The Sociopath Next Door Read online

  The covetous sociopath is the ultimate wolf in sheep's clothing, and in Doreen's case, the disguise is especially elaborate. Doreen is a psychologist, or, at any rate, everyone at the hospital believes she is a psychologist, which for Doreen Littlefield's purposes is much the same thing. The truth, should anyone ever discover it, is that she has no psychology license, nor does she have a doctoral degree. When she was twenty-two, she did receive a bachelor's degree in psychology from her state university back home, but that is all. The rest is an extravagant charade. When they hired her as a postdoc at the hospital, they checked her references, but these were both very prominent men who had succumbed to certain embarrassing liaisons with her, though they should have known better. The hiring committee did not check the credentials she listed. Because she came so prestigiously recommended, they simply assumed she had a Ph.D. After all, who on earth would lie about a thing like that? As for her ability to behave like a psychologist well enough to fool the professionals and the patients, Doreen has always felt, and apparently she is borne out in this opinion, that a person can learn a lot by reading books.

  Doreen has just seen her recovering eight o'clock patient, drop-kicked him into an acutely paranoid state as retribution against an innocent colleague, and sent him off to be medicated and confined to a locked unit. What does she do for the remainder of the day? If we were to rejoin her in her office, we would find that she calmly meets with the rest of her scheduled patients, makes phone calls, does paperwork, and goes to a staff meeting. We would probably not see anything out of the ordinary. Most of her behavior would look normal to us, or close enough to pass. Perhaps she does not do her patients very much good, but she does them no obvious harm either, except in those instances, like this morning, when manipulating a patient will serve to damage a colleague she has targeted.

  Why would she direct her skills against psychiatric inpatients? They have nothing she wants. They are disenfranchised by the world, and she can feel powerful merely by sitting in a room with them. The exception might be the occasional female patient who is a little too attractive or, worse, a little too smart. Then Doreen might have to bring her down a peg or two, tweak a bit of the self-hatred that is usually already there in these patients. In her role as a psychotherapist, she finds this ridiculously easy to do. The setup is always one-on-one, and the patient never understands what hit her well enough to complain to anyone outside of the therapy room.

  But when people do not provoke in Doreen a desire for something they have, or for something they are, then she does not target them. To the contrary, she may be especially charming and courteous when she believes that certain underlings, as she thinks of them, are useful in maintaining her sheep's-clothing disguise, a disguise that includes a presentation of herself as an extraordinarily nice, caring, responsible, and pitiably overworked person. For example, when Doreen is preparing to leave work on the day she has secretly sabotaged Jackie Rubenstein and Dennis, she makes sure to stop by Ivy's desk for an endearing little chat. She tries to do this every evening. Ivy is the secretary-receptionist for the professionals on the ward, and one never knows when such a strategically placed person may come in handy.

  Doreen comes out of her office, collapses into one of the reception room chairs, and says, “Oh Ivy! I'm so grateful this day is over!”

  Ivy is twenty years older than Doreen. She is overweight and wears big plastic earrings. Doreen thinks she is pathetic.

  Ivy replies to her warmly, “I know. You poor thing. And that poor Dennis! I'm no doctor, but I do see the patients around, you know, and I sort of had my hopes up. . . . I guess I was wrong.”

  “No, no. You're very observant. He did seem better for a while. This work breaks your heart sometimes.”

  Of course, this morning the two no-nonsense attendants carrying Dennis off the ward passed right in front of a wide-eyed Ivy. She now looks at Doreen with concern.

  “You know, Dr. Littlefield, I worry about you.”

  As Ivy makes this confession, she notices that Doreen's eyes are pooling with tears, and she continues in a lower voice, “Oh my, today was terrible for you, wasn't it, dear? I hope you won't think I'm getting too personal, but you're so sensitive to be doing this kind of work.”

  “No, no, Ivy. I'm just tired, and of course I'm sad about Dennis. Don't tell anyone—I'm not supposed to play favorites—but he's special to me, you know? I wish I could just go home and get a good night's sleep.”

  “Well, that's exactly what you should do, dear.”

  “I wish I could, but what with the emergency and all, I didn't get my paperwork done, and I think I'm going to be up half the night doing it.”

  Ivy glances at Doreen's bulging briefcase and says, “You poor thing. Let's think of something nice, maybe, to get your mind off . . . well, what happened today. How's that new Maltese doggy of yours?”

  Doreen blots her eyes with the back of her hand and smiles. “Oh, he's terrific, Ivy. Actually, sometimes he's so cute I could just eat him up.”

  Ivy chuckles. “Well then, I'll bet he's waiting for you. Why don't you go on home now and give him a great big hug?”

  “Better not be too big. I'll squish him. He's teeny.”

  The two women laugh together over this, and then Doreen says, “Ivy, Ivy. You know, I think you should be the psychologist. You always know how to put me in a better mood. I'll see you bright and early tomorrow, okay? We'll just keep on keeping on, I guess.”

  “I'll be here,” affirms Ivy. She beams as Doreen picks up her briefcase and walks away, listing a bit to the briefcase side.

  Doreen walks back to the lot where she left her car, and there she encounters Jenna, owner of the beat-up Escort she parked beside this morning. Jenna is a new intern at the hospital, and, unlike Ivy the receptionist, she is young, bright, and pretty. She has long, lovely, stick-straight auburn hair, and Doreen has targeted her.

  “Hello, Jenna. Going home?”

  Jenna blinks at the obvious question, which she thinks is probably criticism, since interns are expected to work slavishly long hours. But she recoups. “Yeah. Yes. Going home. You, too?”

  Doreen looks concerned. “What about that emergency conference at Chatwin Hall?”

  Chatwin Hall houses a ward directed by the stern and fearsome Dr. Thomas Larson, whom Doreen knows to be Jenna's primary supervisor. There is, of course, no conference there right now. Doreen has made this up on the spot.

  Jenna turns ashen immediately. “There's an emergency conference? Nobody told me. When? Why? Do you know?”

  Doreen, now taking on the demeanor of a schoolmarm, looks at her watch and says, “About ten minutes ago, I believe. Didn't you pick up your phone messages?”

  “Yes, of course I did, but there really wasn't anything about a conference. Dr. Larson's office?”

  “I suppose.”

  “Oh no. Oh my God. I've got to . . . I should . . . Well, I guess I'll just get there as fast as I can.”

  “Good idea.”

  Jenna is too panicked to wonder why Dr. Littlefield knows about a spur-of-the-moment conference that does not even involve her. The young intern dashes out of the parking lot and begins to run in her leather pumps across an acre of rain-soaked hospital lawn. Doreen stands in the parking lot and watches her go until, still sprinting, she makes a turn around the far side of a building and disappears from view. Reflecting in satisfaction that Chatwin Hall is located on the extreme opposite end of the grounds, Doreen gets into the BMW, checks her makeup in the rearview mirror, and starts for home. Tomorrow, or the next day, she will come across Jenna again, and Jenna will ask her about the conference that did not exist. Doreen will just shrug and look hard into Jenna's soft eyes, and Jenna will back off.

  Sociopathy Versus Criminality

  Doreen Littlefield will never be prosecuted for her deeds, including practicing psychology without a license. Dennis's influential uncle will never discover who she really is, nor will most of her other patients or their families. The
professionals at the hospital will never pursue her legally for her criminal deception of them. She will never be punished in anything like a commensurate way for the countless psychological assaults she commits. In the end, she is a good illustration of the difference between a sociopath and a criminal, which is, astoundingly, the same thing that separates a naughty three-year-old girl who is seen as well behaved from one who is scolded for taking candy from her mother's purse. The difference, quite simply, is whether or not she gets caught.

  And adults getting caught for committing acts without conscience is apparently more the exception than the rule. Since 4 percent of the entire population is sociopathic, one might reasonably think that our prison system is filled to overflowing with sociopaths, to the exclusion of other types of people. But this is not the case. According to Robert Hare and other researchers who test convicts, on average only about 20 percent of prison inmates in the United States are sociopaths. Hare and others are careful to note that this 20 percent of the prison population accounts for more than 50 percent of the “most serious crimes” (extortion, armed robbery, kidnapping, murder) and crimes against the state (treason, espionage, terrorism), but the actual sociopathic head count in prisons, for both men and women, is only about two in ten.

  Put differently, most identified criminals are not sociopaths. Rather, they are people with more normal underlying personalities whose behavior is the product of negative social forces such as the drug culture, child abuse, domestic violence, and cross-generational poverty. The statistics mean also that very few sociopathic crimes are ever brought to the attention of our legal system—that very few sociopaths are criminals in the formal sense. The most common sociopathic profile, like Doreen's, involves ongoing deception and camouflage, and only the most flagrant crimes (kidnapping, murder, and so forth) are difficult for a reasonably intelligent sociopath to conceal. Some—by no means all—of the sociopathic armed robbers and kidnappers get caught. The Doreen Littlefields of the world seldom do, and even when they do get caught, in the sense of being found out, they are rarely prosecuted. The result is that most sociopaths are not incarcerated. They are out here in the world with you and me.

  In the next chapter, we will discuss the many reasons why people of conscience have so much difficulty “seeing” and dealing effectively with people who have no conscience. These reasons range from the fear tactics used by sociopaths to our own misplaced sense of guilt. But first, let us return to the hospital once more, this time to see Dr. Jackie Rubenstein's miracle, two miracles in fact.

  It is now four days after Dennis was boarded to a locked unit, a Sunday, and the hospital grounds are empty except for a small car that travels up the narrow drive to Dennis's building and stops by the front door. Dr. Rubenstein steps out and digs in her coat pocket for the tremendous, almost medieval master key that will let her both in and out of the three-story stone building. Even now, after eight years of work at the hospital, she clutches the heavy passkey in her hand, rather than putting it back in her pocket, after she enters a unit like this one and hears the door lock behind her. She has come to try, one more time, to get her terrified patient Dennis to talk to her. When she walks onto the ward itself—and yet another metal door closes behind her and locks—she sees Dennis sitting on a green vinyl sofa and staring at a television that has not been turned on. He looks up, their eyes meet for a moment, and, to her surprise and relief, he motions for her to come and sit down.

  Then the first miracle happens: Dennis talks. He talks and he talks, and he tells Jackie Rubenstein everything Doreen Littlefield said. And the second miracle is that Jackie believes him.

  From home that night, she phones Doreen and confronts her. Doreen denies everything, and disdainfully accuses her of being drawn into her patient's paranoia. When Jackie refuses to back down, Doreen warns her that she will be damaging her own career if she goes to anyone else at the hospital with such a wild tale. When she hangs up the phone after talking with Doreen, Jackie calls a good friend back in Los Angeles for support. She tells him, only half kidding, that she thinks she may be losing her mind.

  Jackie does not know that Doreen is a fraud, and so from Jackie's perspective, she and Doreen are peers at the hospital. For this reason, Jackie realizes that she will have a hard time pressing her point with the more senior staff. They will assume this is just some kind of dispute between her and Jackie. At worst, like Doreen, they may suggest she is letting her patient's issues become her own. Nonetheless, on the following morning she walks into the office of the director of her unit and tells him what has happened. His gray-bearded face reddens, which Jackie finds curious, since he does not seem to be angry, either at her or at Doreen. She wonders, as she has wondered vaguely before, whether he and Doreen have had an affair.

  After he hears Jackie out, the director does not take quite the disdainful approach Doreen did on the phone, but he does respectfully remind Jackie of how easy it is to see elements of credibility in the delusions of intelligent paranoids. He says he very much doubts that anything Dennis told her actually happened, and he expresses the hope that she and Doreen will not carry this disagreement out indefinitely. Such a rift would be bad for the unit. And so, in all important respects, Doreen gets away with what she has done, as usual. The happier news is that Dennis's therapy with Jackie is not permanently disrupted, and he is soon discharged from the hospital.

  The end of Doreen Littlefield's charade eventually comes, as it so often does for covetous sociopaths, not with a bang but a whimper, and instigated by someone outside of the system. In Doreen's case, the successful whistle-blower is a consumer advocate who appears twice a month on a local television show called Buyer Beware. Six years after Doreen's psychological assault on Dennis, this local celebrity's wife is hospitalized for depression, and, completely by chance, Doreen is assigned as her therapist. Rankled because he believes his wife's therapy is somehow mucking up his marriage, he uses his expertise to investigate Dr. Littlefield, and readily discovers what she is—or rather, what she is not. He at once approaches the business director of the hospital and explains that if the hospital will kick Doreen out immediately, find a new therapist for his wife, and forgive his wife's entire hospital bill, he will not expose Doreen and the hospital on television. He points out quite reasonably that forgiving one bill is a lot less expensive than paying back the hundreds of bills, or worse, that will be brought against the hospital should Doreen's credentials, or the lack thereof, be broadcasted.

  Reading the file he is shown, the business director is clear on the concept right away, and on her fortieth birthday, in the middle of eating cake at a little office party organized by Ivy, Doreen is abruptly summoned to the administration building. In the business director's office, the business director, the medical director, and the director of nursing (who wants to be present just because she hates Doreen so much) inform Doreen that security will escort her to her car and then monitor her to make certain she leaves the hospital grounds. Doreen tells the three directors that they are making a big mistake, that the consumer advocate is lying because he does not like her, and that she will sue them.

  She drives away, and though she was there for fourteen years, no one at the hospital ever hears from her again. The hospital administration does not pursue the matter, for the obvious reasons of public embarrassment and medical liability, and there is a collective sigh of relief when she simply vanishes. In their private conversations about her, the director of nursing and Jackie Rubenstein speculate that Doreen is somewhere else, in some other state, still practicing psychology.

  Most of the people at the hospital have vast quantities of conscience, and so why, when they finally find out about Doreen, do they let her go without a fight, most likely to strike again somewhere else? And why, in a psychiatric hospital, was she so hard to see in the first place? In general, how can any of us live, as we all do, among significant numbers of destructive liars and con artists and fail to confront them, or even notice them? As we are abou
t to see, there are answers to these crucial questions, and also ways we can begin to change our responses to the slippery phenomenon of sociopathy.

  FIVE

  why conscience is partially blind

  It is easy—terribly easy—to shake a man's faith in himself. To take advantage of that to break a man's spirit is devil's work.

  —George Bernard Shaw

  If she had thought she could get away with it, Doreen Littlefield would have run Jackie Rubenstein down with her BMW, rather than merely sabotaging her work. And—more amazing still—if she had crushed or killed Jackie, or anyone else, Doreen would have experienced no guilt or remorse, much less the horror most of us would feel if we ended another person's life. Her blood pressure would not have risen one point, at least not from any negative emotion having to do with the victim. Doreen has no such sense of things, no seventh sense of human connectedness to make her feel sick over the consequences of her actions. For most of us, killing someone would result in shock, followed by life-altering anguish, even if we had not liked that person. For Doreen, such an act, provided she was never caught, would be experienced as winning. This difference between normal emotional functioning and sociopathy is almost too fantastic for those of us with conscience to grasp, and so for the most part, we refuse to believe such a hollowness of emotion can exist. And unfortunately, our difficulty in crediting the magnitude of this difference places us in peril.

  Even without murdering anyone with her car, or her own two hands, Doreen causes untold damage to the people around her. In fact, diminishing other lives is her primary goal. Since she uses the authority trappings of an inpatient psychotherapist, one day, as a side effect of the vengeful campaigns she conducts, she may push a patient into suicide, if she has not done so already. And yet for fourteen years, a large group of good people, the members of an entire psychiatric hospital staff who would spend their last ounce of strength attempting to prevent a patient's suicide, are blind to what she is, and when they discover her deception, they do not try to stop her. They simply watch her drive away.