A (former) friend of mine shows lots of symptoms of a psychopathic disorder.

Years later after we both met the last time, I'm still not sure whether he is/was aware of this disorder or not.

So my question:

Is a person with potentially psychopathic behaviour aware of why he behaves like he does or not?

Plus: If he is aware, do such persons usually suffer from that knowledge/disorder or like it?

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    $\begingroup$ Regarding the downvote: Is there something about my question that makes it bad for this site? (serious question!) $\endgroup$ – Uwe Keim Apr 15 '14 at 4:12

It is important for us not to mix up the two words psychopathy and psychosis...

The term “psychosis” has its roots in the ancient Greek words for an aberration or abnormality (osis) of the mind or soul (psyche). Thus, the psychotic mind is literally a mind that has stopped functioning normally. A psychotic person has lost the capacity to think and behave rationally, and this usually results in greatly impaired contact with reality. The most typical manifestations of psychosis are bizarre and false beliefs (delusions), and unusual or false perceptions (hallucinations?).

Certain mental illnesses are commonly associated with psychotic states, especially schizophrenia, and less frequently, bipolar disorder. Their brains are malfunctioning in such a way that they have lost the capacity to correctly judge things in their environment and to relate to others in a coherent, rational fashion.

On the other hand, the term “psychopathy” was first used in the early 19th century to describe a pathology of personality characterized by an extreme lack of empathy that leads to guiltless and remorseless use and abuse of others. Shallow emotions, a chilling lack of fear, extreme manipulativeness, frequent and seemingly nonsensical lying, and behavioral irresponsibility are common, as is the tendency to display superficial charm.But, although psychopaths have a world view greatly aberrant compared to most, they are neither out of contact with reality nor incapable of rational thought. In fact, their thinking is often distinctly rational and goal-oriented.

With that said I'm going to go ahead and assume that you were of course referring to psychopathy in your question, and tell you that virtually all psychopaths know early on in life that they're different from other people. Perhaps not to the extend of knowing about their disorder, but they are in touch with reality and can definitely be able to notice certain differences between themselves and other people such as differences in emotion.

  • $\begingroup$ Thanks you. Your last paragraph is what I was looking for :-). So If I'll ever meet my former friend again and tell him that his psychopathy (and its results) was the reason why I discontinued to have contact with him, he would probably be upset, because while knowing he is different does not necessarily mean he has a name ("psychopath") for his behaviour. Right? $\endgroup$ – Uwe Keim Apr 15 '14 at 4:10
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    $\begingroup$ That's right. There is such stigma against psychopaths, often with good reason. The best way to go about it is to be gentle, reminding him that he has no control over who he is, but has some sort of control for controlling it, so to speak. $\endgroup$ – Landacut Apr 15 '14 at 8:14
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    $\begingroup$ @UweKeim: It would be clearer to tell him the specific behaviors that you couldn't handle. This is probably true in general, because every psychopath (and every other kind of person for that matter) is somewhat different from others in their class. What defines their commonalities is actually fairly vague and can be hard to relate to directly. Besides, what defines psychopaths might not actually be what you objected to personally, so there's some room for miscommunication there too. $\endgroup$ – Nick Stauner May 3 '14 at 3:20

Sometimes they are aware.

For example a manic-depressive is mostly aware of having a psychological problem during his depressive phases, but will usually perceive himself well while manic. Schizophrenics often understand that they have delusions, but many of them can only understand this while they are in a non-delusional phase.

Sadists are often aware of being deviant, but usually enjoy what they do. Manics don't suffer either, but feel grandiose.


Oops, I read "psychiatric disorder" instead of psychopathy. So obviously most of what I wrote is beside the point here. Read what I wrote about sadists and ignore the rest. Sorry.

Source: Working in a psychiatric ward.


This question essentially addresses the difference between ego-syntonic and -dystonic disorders.
To quote Wikipedia:

Egosyntonic is a psychological term referring to behaviors, values, feelings that are in harmony with or acceptable to the needs and goals of the ego, or consistent with one's ideal self-image.

Egodystonic...is the opposite of egosyntonic and refers to thoughts and behaviors (e.g., dreams, impulses, compulsions, desires, etc.) that are in conflict, or dissonant, with the needs and goals of the ego, or, further, in conflict with a person's ideal self-image...

Many personality disorders are considered to be egosyntonic and are, therefore, difficult to treat. Anorexia nervosa, a difficult-to-treat Axis I disorder, is also considered egosyntonic because many of its sufferers deny that they have a problem.

Obsessive compulsive disorder is considered to be egodystonic as the thoughts and compulsions experienced or expressed are not consistent with the individual's self-perception, meaning the patient realizes the obsessions are not reasonable.[2][3]

The egosyntonic and egodystonic concepts are studied in detail in abnormal psychology; while 'the notion of ego syntony plays an important part in psychoanalytic ego psychology'.

More generally, internalizing / mood and anxiety disorders tend to be ego-dystonic, while externalizing disorders tend to be ego-syntonic. This latter class includes substance abuse and antisocial disorders, such as those that relate to strong dark triad traits. This in turn includes psychopathy, and in the dark tetrad model, sadism as well, which @what has mentioned in his answer. Of course, it would be unwise to speculate about your friend's personal case, but in general, psychopaths are likely to lack some degree of self-awareness. More definitionally, psychopaths lack remorse, and often "suffer" more from megalomaniacal delusions. There is a thin line between primary psychopathy and narcissism, and disorders don't get much more ego-syntonic than narcissism.

2. Aardema, F. & O'Connor, K. (2007). The menace within: Obsessions and the self. International Journal of Cognitive Therapy, 21(3), 182–197.
3. Aardema, F. & O'Connor, K. (2003). Seeing white bears that are not there: Inference processes in obsessions. Journal of Cognitive Psychotherapy, 17(1), 23–37.

  • $\begingroup$ Thanks a lot Nick, your answer is really awesome! (reading through the links and with the help of a good English-German dictionary I do think I understood most of it) $\endgroup$ – Uwe Keim May 2 '14 at 4:52
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    $\begingroup$ Ah, that sounds harder than I intended it to be! Feel free to comment if there are any words you can't translate; I don't speak German, but with the help of Google Translate, maybe I can help you find a decent synonym or phrase with the same meaning as some of the more obscure and technical words. $\endgroup$ – Nick Stauner May 2 '14 at 6:38
  • $\begingroup$ It's really perfect, Nick, thanks for your kind words and help. Your answer gave me a good, broad understanding and will help me to decide how to behave if/when I ever meet my former friend (which I, in certain phases, really did/do like) $\endgroup$ – Uwe Keim May 2 '14 at 7:12

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