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May 6, 2025 30 mins

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) unveil the darkest aspects of personality, focusing on narcissism at its most severe forms. We explore the spectrum of personality types that range from mildly unpleasant to dangerously malignant, discussing examples and case studies that illustrate their risk in relationships. We specifically unpack narcissistic and paranoid personality disorders, malignant narcissism, antisocial personality disorder, psychopathy and sociopathy, and sadistic personalities. While further exploring the characteristics, overlaps, and distinctions among these disorders, we end with a discussion about terrorism and extreme manifestations of sadism.

Chapters 01:02 Stone’s Spectrum of Darkness 01:23 Level 1: Negative Traits 04:35 Level 2: Narcissistic & Paranoid Personality Disorders 07:23 Paranoid Personality Disorder 10:48 Level 3: Malignant Narcissism 13:47 Level 4: Antisocial Personality Disorder 15:08 Antisocial vs Narcissistic Personality Disorder 17:24 Antisocial Personality vs Psychopath 18:38 Level 5: Psychopathy 21:27 Level 6: Sadistic Personalities 28:54 Summary & Closing

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Episode Transcript

Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Welcome to the Personality Couch podcast,
where we discuss all things personality
and clinical practice.
I'm your host, Doc Bok,
and I'm here with my co-host, Doc Fish.
We are both licensed clinicalpsychologists
in private practice,
and today we are continuing our series
on pathological narcissism,

(00:22):
which led us to the concept ofmalignant narcissism
and other darker themes.
We questioned, is there a worsepersonality type
than extreme narcissism?
Can a narcissist be a psychopath?
Is there something even worsethan a psychopath?
Well, we're about to tell youwhere our research led.

(00:44):
So join us down a dark, multifacetedrabbit hole
as we discuss the spectrum ofpersonality darkness
and how bad it can get.
Let's dive in.
Yay, darkness.
Okay, so in our research, we foundsomething exciting.
Michael Stone, a forensic psychiatrist,

(01:05):
came up with an entire spectrum
that helps us understand how narcissism
and its associated traits can devolve
into psychopathy and destruction.
This spectrum has six main components,
each one getting progressively worse.
So level one contains allthe negative traits.

(01:28):
Well, actually, this is the mildend of the spectrum
where we have people
with negative personalitycharacteristics.
Stone listed a few of these asabrasive, argumentative,
deceitful, discourteous, tactless,and vindictive.
Okay, so level one,
these are the argumentativejerks of the world.

(01:48):
Like people don't like them.
They may seem charming at first,
but they're just prickly porcupine people
or people that don't fit intothe social herd well,
they're just annoying, right?
So they're not necessarily dangerousor even criminals,
and they probably wouldn't harm others.

(02:08):
They're just all around unpleasantto be with
and likely have issues in relationships
because of their personalities.
Right, so maybe an example mightbe a meddlesome teacher
who has problems with boundaries
and is like up in everyone's business.
Right, so still pleasant maybe,but annoying.
Or then I think of like thequarrelsome guy

(02:31):
at the hardware store who's liketrying to fix his lawnmower
and yelling at the clerk
who's out of the screw sizethat he needs.
Yes, that's a good one.
Maybe an envious neighbor who'slooking over your fence
and like one ups your purchasesor your lawn care.
Oh, like you got mulch?
Me too, what are the odds?
Like mine's better.

(02:52):
Let me park my behind onmy fancy lawn chair
and watch you plant your flowers.
Yeah, so these are the painin the butt people
who just get on your nervesor are argumentative
and prickly, but they won't kill you.
Nope, but let's peel back another layer
and go more severe, but stillwithin level one.

(03:13):
Okay, so let's zoom in to moreseverely negative traits.
So a person with these traitsmight be aggressive,
hostile, cruel, predatory, malicious,and scheming.
Now these can occur outside of thecontext of crime and harm.
Like we're not at a level ofcriminal darkness.

(03:34):
Yeah, it's just dusk.
Like the people we really,really don't like
or maybe even hate, they're worsethan just annoying
like the types we just talked about,
but they're still in level one,
but just a more severe form
of negative personality characteristics.
So for example, the grudge holding boss
who punishes the employee for onemistake two years ago

(03:58):
that he just can't lift down.
Or the jealous partner who'sconstantly checking
their lover's phone for any indicationof foul play
despite no evidence.
Maybe a slanderous, vengefulex-girlfriend
who promises a smear campaignto end your career
after breaking up with her.
Yep, she won't kill you, but she'llmake your life miserable.

(04:22):
Exactly, yep.
Negative personality traits ofall shapes and sizes.
That's level one.
Yep, okay.
So going a level deeper intothe darkness abyss.
Level two, disordered personalitieslive in this dark space.
Okay, so specifically narcissisticpersonality disorder

(04:45):
and one called paranoid personalitydisorder.
Now we have talked extensively
about narcissistic personalitydisorder in this series.
So we're not gonna camp for here long,
but these personalities areself-important,
entitled, exploitative, enviousand arrogant.

(05:06):
They need excessive admiration.
They believe they're special
and they fantasize about unlimitedsuccess and power.
They also can lack empathy.
Now let me just be clear
that while the average narcissistwon't kill you
at extreme levels coupled
with other severe personalitytraits, they can.

(05:29):
So Stone, the well-known forensicpsychiatrist,
wrote an article with murderous examples
that are actually useful to understandthe differences
in the darkness layers.
So let's look at a couple of narcissisticpersonalities
motivated by greed, abandonment,
and a wish to upgrade their partner.

(05:51):
Ooh, first is the motivation of greed.
So one guy killed his mom andanother family member
after putting pipe bombsunder his mom's car
because she was about to financiallycut him off
and because he was hoping
for like a $10 million inheritancepayout.
Oh, hello.
Yikes.
Narcissistic greed.
Now, another lady, her image waswounded by abandonment

(06:15):
because her husband cheated
because he found her like crueland self-absorbed
and she hired someone to kill him.
Oh, yeah.
It seems to be like a case of like,
no one can have him if I can't.
Ooh, woof, my word.
The last example of narcissismmotivated to kill.
So this guy wanted to start a restaurant

(06:35):
and be with a younger, prettier woman,
but his wife got pregnant and wenton a board when he asked.
So he killed her and the unborn baby
and shot himself non-fadily
to make it look like someone else did it.
All in pursuit of an image upgradeand a grandiostream.

(06:55):
Yuck.
Oh, okay.
So these stories are from Stone.
So he provided us with this information
about these case scenarios.
Yikes.
Whoa.
Okay, so that was narcissistic personalitydisorder gone bad,
but there's also paranoidpersonality disorder

(07:17):
all within this level two.
So similar to narcissisticpersonality disorder,
paranoid personality disorder canbe mild or more severe.
So not all paranoids are goingto be dangerous,
but those who are paranoid andcommit violent crimes
have the more severe criteria.

(07:40):
Also, this type of personalityis more likely
to commit mass murders,
meaning three or more murdersin one outburst.
Yikes, I'm thinking like maybethe Oklahoma City bombing
type mass murder or like shootingup an establishment
for mass carnage.
That.
Oh gosh.
And this is only level two of six, right?

(08:02):
Wow.
Stone also had an interesting quote.
He said, among mass murderers,
only 10% that he studiedwere psychopaths.
While most of the others weredisgruntled, paranoid men
who held grudges were pathologicallyjealous
and vindictive.
End quote, Doc Fish.

(08:24):
Tell me these examples that he used.
Okay, so he highlighted one in a marriage
where a guy killed his wife andsix year old daughter
a few days after his wife told him
she was going to file for divorce.
Gosh.
Now there was a history of pathologicaljealousy,
control and physical abuse,
though he was a devout Christian

(08:44):
and former lieutenant commanderin the Navy.
Jeez.
Y'all watch out for these wolvesin sheep's clothing.
Cannot say that enough.
And if domestic violenceis happening, run.
It could mean your life.
Another example he used was aguy who stalked a girl.
She refused to date him

(09:05):
and eventually she even fileda restraining order
which he did not respect.
Oh dear.
Now he threatened to kill her
if she didn't go out with him,
which also led to him getting fired.
Two years later, he killed seven people
and wounded four, including thegirl at his old workplace.
This was turned into a movie in 1993

(09:26):
called "I Can Make You Love Me."
Whoa, okay, I'm still reelingfrom this story.
Like that level of vindictivenessand control for love.
And I also think of like thedangers of stalking
right here in this story.
Oh dear.
Right, like that's a two year grudge.
The last example Stone provided

(09:48):
of a paranoid personality disorder
is a male student who died by suicide
after he calmly shot andkilled five people
he felt were conspiring against him
and his achievements in his university.
So they included professors,
his mentor and his rival peer.
My word, that's awful and scary.

(10:10):
Holy cow, that grudge,
I'm hearing kind of a theme hereof like harboring grudges.
So different combinations of symptoms
within both paranoid personality disorder
and narcissistic personality disorder
can make these characters moremild and less dangerous,
but then some combinations can bemore severe and harmful.

(10:35):
Like the examples.
Right, exactly, yeah.
So these are heading morein the direction
of psychopathy here.
Holy cow, okay.
But we gotta go a level deeperinto the darkness.
So level three, you might recognize it,
it's malignant narcissism.
Okay, so again, we're not gonna camp here

(10:56):
since we just talked aboutmalignant narcissism
in our subtype episodes,
which I'll link on YouTube if you'rewatching on there.
But briefly, this specialflavor of narcissism
has antisocial behavior, sadismand aggression,
and of course, paranoid flavors.
So basically these types arefull of themselves.

(11:17):
They go against social norms and rules,
they hurt others and they believethey're justified
in doing so because everyoneis out to get them.
So I love this quote by Stone.
He says, "If there is, from thestandpoint of personality,
one red threat running throughthe majority

(11:38):
of violent crimes, this wouldbe narcissism.
Whoever chooses, that is to stab,choke, bludgeon, shoot,
tie up, sequester, et cetera,
is obviously putting hisown needs, desires,
and entitlements in first place,
and is giving no place at allto the needs, desires,
and entitlements of the victims."

(12:00):
This level of self-centerednessis so vile,
like that life itself couldbe snuffed out
so that that person can meet theirown needs of the self.
And as we always say,
pathological narcissism isthe first ingredient

(12:20):
in all problematic personalities.
So malignant narcissism is narcissismgone way bad.
It's rotten.
So this is where personality darknessmeets the night.
Right.
So an example of a violentmalignant narcissist
was described in a 2016 case study.

(12:42):
There was a doctor who murderedhis wife and children,
but actually he wasn't actually a doctor.
He was faking it.
He was faking his social status.
Now upon narcissistic injury,
because he thought he wasabout to be caught,
he killed his close relatives
and unsuccessfully attempted suicide.
So he maintained his relationships

(13:03):
and technically had loyaltyto his family,
considering them part of himself
and taking them out with him.
Oh, unbelievable.
Okay, so the family here
was a narcissistic extensionof the self, yuck.
So while murderers and violent criminals

(13:25):
probably wouldn't meet the criteria
for narcissistic personalitydisorder in the DSM.
So the DSM type is not typically violent,
but there is a heaping dose of narcissism
in all violent offenders, especiallymalignant narcissism.
Especially.
But we gotta go deeper into the night.

(13:47):
Level four is antisocial personalitydisorder.
So when malignant narcissism gets worse,
it heads towards antisocialpersonality disorder.
I think a brief comparisonis warranted here
because there are some similarities.
There's actually a 25% overlap
between narcissistic personality disorder

(14:08):
and antisocial personality disorder
as they share traits like strongreactions to criticism,
feeling invincible, and aggressionor violence
in reaction to threats to superiority.
Okay, and then of course we haveother obvious traits
like grandiosity, need for admiration,
exploitation of others, andlack of empathy.

(14:29):
So those are the things that overlap
with these two personality disorders,
but they are different.
Okay, so antisocial personality disorder.
Definition time, it is a patternof disregard for
and violation of the rights of others,
criminality, impulsivity,

(14:50):
and a failure to learn from experience.
So the key here is rule-breaking,law-breaking even,
going against social rules and norms,as well as aggression.
So not having any concern
for the impact of their behavioron others.
So those with NPD, or narcissisticpersonality disorder,

(15:12):
might understand cognitively
that they're supposed to feel sad
when their partner's dog dies,
but they don't feel it inside.
But someone with antisocialpersonality disorder
doesn't even take the beat
to recognize they're supposedto feel sad.
Like they truly don't care.
Right, like they are capable of caring,

(15:34):
but they often lack the motivationto care.
That's right, yeah.
So let's look at an example of someone
with antisocial personality disorderthat killed others.
Note this person was not a psychopath.
That is yet to come.
Ooh, okay.
This guy had a long childhoodhistory of law-breaking,

(15:55):
including fighting, violence, theft,
and gang-related crimes.
After getting out of Juvia age 19,
he became a bodybuilder.
He was a leader of a prominent gang
with a goal to protect locals
from other gangs and police brutality,
and during this time, he wasalso a youth counselor.

(16:15):
Oh.
Now, unfortunately, he later wasaddicted to angel dust
and killed one person in a store,then three in a motel,
while he was stealing moneyto buy the drugs.
Of course.
He was arrested, sentenced to death,
and upon incarceration,
he did commit assaults against others.
However, he ended up pursuing education

(16:36):
and writing books discouragingBlack youth
to engage in gangs.
Oh.
He was actually nominated forthe Nobel Peace Prize,
but was executed in 2005.
Whoa, what a story.
So he changed over time,
but ultimately, he couldn't outrunthe consequences

(16:58):
of his antisocial rule-breakingkilling even past.
Mm-hmm, wow.
Yeah, so this example, itpulls at the heart.
The behaviors are not okay,like absolutely not.
Right.
The reform is emotional,
and that is why it's really important
we discuss the difference
between antisocial personalitydisorder and psychopathy.

(17:22):
Yes, yes.
So the first distinction is thatantisocial children
don't usually become antisocial adults,
and young adults with antisocialpersonality disorder
will burn out around their 40s.
Ooh.
This aging out dynamic does nothappen in psychopathy.

(17:42):
Psychopathy is consistent andit stays lifelong.
That is an important distinction.
Yeah, so this reminds me ofthe previous example.
He essentially aged out ofhis criminal behavior
as someone with antisocialpersonality disorder,
and he wanted to discourage othersfrom doing what he did.

(18:04):
Yeah, so then interestingly,
HAIR created the gold standardmeasure of psychopathy.
So we've probably heard of it,
it's HAIR's Psychopathy Checklist.
So essentially, antisocial personalities
score lower on this checklist thanthose with psychopathy
who are admitting more severetraits and behaviors.

(18:27):
So they're not the same.
Psychopathy is way more severe.
But that takes us to the penultimatelevel of darkness,
level five, psychopathy.
There's two layers of psychopathy.
The lesser layer is psychopathywithout violence,

(18:47):
which is also sometimescalled sociopathy,
so there's major disagreement about this.
Then there's actual psychopathywith violence.
Right, so let's go back to HAIR
and look at his research,
since he's the most well-knownfor studying psychopathy.
So he states it well,
noting that psychopaths are, quote,

(19:10):
"intraspecies predators who usecharm, manipulation,
intimidation, and violenceto control others
and to satisfy their own selfish needs."
Oh!
So it's also notable that psychopathyis marked
by a complete absence of empathy,
not just impaired empathyor blocked empathy,

(19:33):
as we've talked about with certainflavors of narcissism.
So there's actually brain imaging
and studies that support this, right?
So psychopaths just don'texperience emotions
the same way that normal humans do.
An example of a nonviolent psychopathor sociopath

(19:53):
would be the guy who engaged
in the biggest known Ponzischeme manipulation
and swindled people out ofbillions of dollars.
While he was nonviolent with no assaults,
he definitely did not have empathy
and he preyed on his clients.
Yeah.
But let's contrast this toviolent psychopathy.
So there was one guy convictedof 11 murders.

(20:16):
Now he has the sexually violent crime,
like triad of childhood, bedwetting,
animal torture, and fire setting.
Fast forward though, he ended up raping
and strangling 11 prostitutesuntil his arrest.
Oh my world.
So interesting.
Stone actually interviewed him in prison
and noted a lack of remorse,cheerfulness,

(20:40):
pathological lying, and grandiosity.
He even embellished his crimesto impress others.
Ew, ew, ew, ew.
Okay, so he was happy and proudabout what he did.
Jolly even.
That is sick.
That is sick.
Okay, so there's definitelya notable difference

(21:02):
between psychopathy without violence
and then the psychopathy with it.
And I can think of lots of differentTV show characters
in movies that depict thesemore sinister types.
But I'm curious, can it get even worse?
And what we found is that apparently so.

(21:23):
So let's go into the darkestblackest night.
Sadism is level six.
Sadistic personalities are common
in those who commit violent crimes,
especially rape and serialsexual murders.
Sadistic personalities almost made it
into the DSM as a diagnosis,
but alas, it only made it intothe appendix in 1987

(21:48):
before being booted out in 1994.
So the DSM now essentially stops
an antisocial personality disorder
with an argument that we don'treally see more severe
or darker pathology in clinical practice.
Like after antisocial,
we're kind of heading into forensiconly settings.

(22:08):
Right, so forensic would belike jail, prison,
sometimes state hospital or NGRI patients
or not guilty by reason of insanity.
So the DSM doesn't cover the full gamut
of personality pathology and dysfunction
that is possible for the human condition.
Just the stuff that's commonin clinical practice,

(22:30):
but personality can go extremely dark.
So let's get back to the mostdangerous character,
the sadistic personality.
Super important to understand
is that sadistic personalityis not solely
about sexual arousal.
Like we're not talking aboutsexual sadism here,
though that can be included.

(22:52):
So the appendix of the DSM-3Rin 1987 noted
that four out of eight of the following
were needed for a sadistic personality.
Doc Bock, what are those sadisticattributes?
Yes, okay, here we go.
So number one, these typesuse physical cruelty
or violence to establish dominancein their relationships.

(23:17):
So like I beat you up, I'm in control.
Number two, they get peopleto do what they want
by frightening them through intimidationor terror.
So compliance through fear.
Number three, they are controllingof the people
in their circles.
So like they won't let usbow sleeve the house

(23:37):
unaccompanied.
Yeah, that's a good example.
Number four, they lie for thepurpose of harming
or inflicting pain on others.
This is an important distinction here.
It's not even to cover their tracks,
like maybe in narcissistic personality.
They do it just to hurt you.

(23:58):
Yeah, number five, they humiliateor demean people
in the presence of others.
So again, not out of unawarenessor being self-absorbed.
They do it because they want to harm you.
Yep, they want to inflict the harm.
Number six, they treat ordiscipline someone
under their control withunusual harshness.

(24:21):
Okay, so like a child, student,prisoner, patient.
Exactly, mm-hmm.
Number seven, they are amusedor take pleasure
in the psychological or physicalsuffering of others,
including animals.
Like they enjoy it and are giddy over it.
Yuck.

(24:42):
Okay, and then number eightis they are fascinated
by violence, weapons, martial arts,injury, or torture.
Like these are real sickos.
Basically, these are the welcomingcommittee to hell.
So a sick example of a sadisticpersonality
is this one guy who actuallyblended into society.

(25:05):
In very, very broad strokes,
his fantasies of bondage, torture,and killing women
kept getting more prominent until his 40s
when he engaged in the actual behaviors,
creating a torture chamber thathe called the toy box.
Oof.
So it's actually possiblehe killed a woman
when he was 13 by tying her to a tree.

(25:27):
Oh, oh, oh.
Okay, so there was an intenselypsychological aspect
to his sadism as he flauntedwhat he was going to do
to his victims before doing it.
Police found 100 videotapes of torture
and evidence of 40 murders.
Oh my gosh.
He also had a female assistant.

(25:48):
Oh my.
But that's all I'm gonna sayabout this example.
It's really sick.
It's really sick.
My goodness.
And this is also a helpfulthing to distinguish
between antisocial.
Like this guy was in his 40s whenit really ramped up
versus the 40s we start tokind of phase out
of that behavior.
He was ramping up the dopaminehit seemingly.

(26:10):
I mean, the words that come to mindwith a case like this
are demented, demonic, twisted,nasty, unfathomable.
Like normal humans don't do this.
Right.
But at the deepest layer ofpersonality darkness,
we have sadistic personalities whothen engage in terrorism.

(26:32):
Oh my goodness.
So this is gonna be the samekind of dynamics
but large scale and often public facing
or instilling terror and fearonto the masses.
So it's the stuff in the news,
but also the stuff that's hiddenin classified files
like torture, pain and power usedin the form of terrorism.

(26:54):
Like to prove a point, to intimidate,to control,
to suppress, to humiliate peoplegroups, countries, regions.
Oof.
So one article noted that Saddam Hussein
probably reached the diagnosticthresholds
for sadistic, paranoid, antisocial
and narcissistic personality disorders

(27:15):
with sadistic being the highest.
Now it was also concludedthat Saddam Hussein
had many of the same personalitydisorders or features
as Adolf Hitler, although sadisticfeatures were stronger
in Hussein than Hitler.
Oh, yikes.
Okay, so this is all just likenasty characters,

(27:35):
really nasty.
And it makes sense as you'retalking about
all the different diagnostic thresholds
that this one theorist thoughtthat Hussein met
because as we go down this spectrum,
we take pieces of all the personalitypathology stuff
that precedes it, right?
So sadistic is at the bottomof the barrel,

(27:57):
it's the worst, but it's also gonnahave the negative traits,
the narcissistic personality disorder
or paranoid personality disorder,malignant narcissism,
antisocial personality disorder,psychopathy,
and then of course, sadism.
So it takes like the whole ladderinto darkness with it.
And yeah, the deeper and darker you go,

(28:19):
you're taking all of thosecharacteristics with you,
which makes you that much worse.
Now you said the bottom of the barrel,
but Stone also said there'sno worst case scenario
of sadism, just as there's no bottomto human depravity.
Oh, that's a lovely thought.

(28:40):
Like there is no bottom.
There's no bottom to the barrel.
Getting worse and worse straightinto Hades.
It's what it seems like.
Yeah.
Oh dear.
So in this episode, we learned allabout the dark spectrum
of personality from least dangerousto the most extreme

(29:03):
within the super dangerous personalitycategories.
So just to recap, we had the negativepersonality traits
followed by narcissistic personalitydisorder
or paranoid personality disorder.
And then in the middle is thatmalignant narcissism
that we've been talking a lot about.
Even worse than that is antisocialpersonality disorder,

(29:23):
which is like the end of theroad in the DSM.
And then we break away from the DSM
and get into more forensic typestuff like psychopathy.
And then the most dangerous is sadism.
Oh, all I can say is beware y'all.
Like whiffs of narcissism is whereall this stuff starts.

(29:44):
Dark thoughts, dark thoughts.
And on that note, we will landthe plane for today
on an unresolved note withmore yet to come
in the personality darkness.
But thank you for joining us today
on this episode of The Personality Couch.
Make sure to check out our blogs
that coincide with these episodes

(30:05):
at www.personalitycouch.com.
And as always, don't forgetto give us a thumbs up
or rate and review us on yourfavorite podcast app.
And on YouTube, hit that bell
so you don't miss a single episode
in our narcissism series and beyond.
Be well, be kind, not sadistic,

(30:26):
and we'll see you next time onThe Personality Couch.
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