Sadistic Personality Disorder

What is Sadistic Personality Disorder?

Sadistic personality disorder (SPD) can be defined as a type of personality disorder in which an affected individual inflicts sadistic, cruel, manipulative, aggressive and demeaning behavior on others. Violence and abusiveness are the hallmarks of the social relationships of a sadist. Such people lack empathy and concern for other individuals and derive pleasure by hurting or humiliating others.

Similarities have been observed between the SPD and the more aggressive variants of antisocial personality disorder. However, an antisocial individual does not normally hurt other people just for fun. There might also be a connection between SPD and sexual sadism, where an individual derives sexual satisfaction and arousal from sadistic acts such as beating and/or humiliating someone.

What is Sadism?

It involves experiencing pleasure from watching others undergo discomfort or pain. The opponent-process theory illustrates the way by which these individuals not only act sadistically, but also take great satisfaction in performing sadistic acts. Individuals having sadistic personalities can display recurrent episodes of aggression and cruel behavior. Sadism can also involve using emotional cruelty, intentionally manipulating other people through the tactical use of fear as well as a long-standing preoccupation with violence.

Whereas certain sadistic personalities do gain pleasure and satisfaction from inflicting suffering and pain upon others, the act of sadism do not necessarily always involve usage of violence or physical aggression. More frequently, sadistic individuals perform aggressive social behaviors and/or enjoy publicly humiliating other people to achieve a feeling of power and control over others.

Sadistic Personality Disorder Classification

There are four different types of sadistic personalities identified by Theodore Millon. An individual sadist might exhibit none, one or even more than one of the following traits:

Enforcing Sadist

This category of sadistic people can often be found within important positions of authority, such as military sergeants, police officers, prison overseers and deans of universities. These individuals are in a situation where they feel that they are the ones who should be in charge of controlling, overseeing and punishing people for breaking laws, rules and regulations. Although they might have the opinion that they are actually acting for common interest, more critical, deeper motives are involved than just that. Enforcing sadists normally seek out rule breakers within their authoritarian domain, or within the society in general, and by doing so exercise the worst punishments they can give out for an individual case. If the enforcing sadists are chosen by society, for e.g.; prison or police stuff, their actions are not perceived to be unfair and they have a greater freedom to dominate, destroy or victimize others at will. These people are supposed to be fair, but their overall personalities are not able to foster limits on their emotions that fuel their vicious, sadistic behaviors. The more they punish and dominate others, the more powerful and satisfied they feel. With more of these acts, their self-image of righteousness gets reinforced which increases their ego. The pleasure that an enforcing sadist can get from dominating and punishing other individuals can reach a level of euphoric intoxication wherefrom they can no more stop their behavior and lose all awareness of reality. However, this does not draw any negative attention as their actions are considered within their range of legal authority to dominate and they behave normally in day-to-day situations.

Explosive Sadist

People having this form of sadistic personality are known to be unpredictably violent as they are disappointed or frustrated with their general lives. They lose control when they feel humiliated and/or hopeless and seek retribution for the deprecation and mistreatment to which they sense they have been subjected to. These violent behaviors get expressed through fearsome attacks and tantrums on others, especially on family members, and through uncontrollable rage. Normally, the explosive sadists feel suddenly threatened in some given situation and then shock others by the abruptly changing behavior. These sadists do not generally move about in grumpy or surly manner and as a result it is difficult to know what might set them off. Although the violence that gets released is nearly always directed at a particular individual, it primarily serves as a form of emotional release for the pent up feelings that the sadist had been holding inside himself or herself.

Tyrannical Sadist

This type of sadistic personality is counted among the more cruel and frightening of all subtypes as they seem to really relish their acts of brutalizing and menacing others. It appears that forcing their unwilling victims to submit and cower provides them with some special feeling of satisfaction. This type of SPD is similar to some extent to the explosive sadist. However, the tyrannical sadists are even more methodical and precise in their actions. They are not trying to release their pent-up frustration like the explosive sadists, but they aim to use violence as a means to inspire fear and intimidation. Another important difference between the explosive sadists and the tyrannical ones is that the tyrannical sadists choose their victims quite carefully to make sure that they are not going to stand up and fight back when they are attacked. The tyrannical sadists normally have a low self-esteem and several inner insecurities that they try to conceal from the world. In order to do this and feel superior, they often overwhelm others by their behavior.

Spineless Sadist

This type of sadist is completely opposite of other three types, as they are extremely insecure and behave like cowards. These people anticipate real danger, project their hostile ideas and strike first, thereby hoping to forestall the antagonist and put forth questions later. Although these sadists are afraid of many things, during times of stress they try to enforce the fears of their enemies. Spineless sadists employ aggressive hostility to portray the idea that they are not intimidated or fearful, which allows them to manage their inner feelings and display exactly the opposite of how they are actually feeling. Their mannerisms can be termed as counterphobic, a trick that allows them to control their personal fears as well as divert and propagate a false aura of self-assurance and confidence. Spineless sadists even seek out scapegoats whom they gang up on as this allows them to live in a state of denial about their own inner states.

Other types of sadistic personalities include the monk-sadists, the narcissistic sadists, etc.

Sadistic Personality Disorder Causes

There are no definite, clear causes for people developing SPD. Some theories indicate that the way a person is brought up plays a major role in deciding if one is going to develop a sadistic personality or not. However, biological factors may play a certain part as well. Most theories commonly point to the fact that sadistic behavior is essentially dependent on the overall upbringing of a person. Unfavorable experiences during childhood or during the early phases of sexual development can greatly increase the risk of development of SPD. Sadism or sadistic personality may even develop in a person through conditioning. For example, a continual connection of some definite stimulus with sexual satisfaction or happiness connected with the misery and anguish of other people or animals can lead to sadism or sadomasochism.

Not much is currently known about the genetic factors or hereditary patterns responsible for this psychological disorder.

SPD: Comorbidity with other personality disorders

It is often found that SPD occurs in unison with various other personality disorders. Studies have revealed that this form of psychopathic disorder is the disorder has the highest extent of comorbidity with other forms of psychopathologic disorders. Sadism, however, has also been spotted in people who normally do not display the other types of psychopathic disorders. A particular personality disorder that is frequently found to affect an individual alongside the SPD is the conduct disorder. Sometimes, narcissistic personality disorder and anti-social personality disorder are also found in people diagnosed with SPD.

Some of the other psychopathic disorders that are frequently found to coexist with the sadistic form include:

  • Depression
  • Bipolar disorder
  • Borderline personality disorder
  • Panic disorders
  • Self-defeating personality disorder
  • Obsessive compulsive disorder
  • Histrionic personality disorder
  • Passive-aggressive behavior

Research indicates that other forms of illnesses, for example, alcoholism, often have a higher rate of comorbidity when involved with SPD.

It is due to the high comorbidity of SPD with other psychopathic disorders that it is difficult to distinguish this condition from other types of personality disorders. Although SPD is no longer counted in the DSM, especially for this reason, the other forms of mental conditions involving sadism (like sexual sadism) can still be found within the DSM.

Sadistic Personality Disorder Symptoms

A person is said to have SPD when he or she displays certain behavioral patterns.

  • A sadistic individual does not hesitate to humiliate people intentionally in presence of others. The shame and disgrace that he inflicts on other people makes him feel larger than life and supremely important.
  • He considers all people to be under his control, no matter whether the other individual is a student, child, prisoner or patient, and treats them in an unkind and harsh manner. All that he hopes to gain is unchallenged dominance within a relationship. Anyone who attempts to break free is dealt with in a cold-hearted, callous manner.
  • A sadistic individual finds pleasure in causing pain to other people or harming them by lying without any apparent reason or without any motive to achieve any other goal. This action of harming others like that makes him feel contented and invincible.
  • Unlike a normal person, a sadistic individual frightens and terrorizes others for getting his job done.
  • He often puts restriction on the freedom of other people within a close relationship. For instance, a spouse may not be permitted to leave the premises of the house unaccompanied or the teenage daughter may not be allowed to attend various social functions. The controlling nature of the person makes it difficult for others to have his or her say. A sadistic person behaves as if his word is final and the ultimate law. Hence it should be obeyed, even if it may seem outrageous and senseless to others.
  • A sadistic individual gets highly enthralled by all forms of violence, martial arts, weapons, injuries, torture or death. He or she channelizes the inner killer instinct in various socially acceptable ways like “studying” as well as admiring historic figures such as cruel monarchs or dictators like Hitler.
  • He does not falter from making use of violence or cruelty for establishing his dominance in any form of relationship. The main goal is to exert full and unbroken control over an individual or situation.

Sadistic Personality Disorder Diagnosis

The condition appeared only in the appendix of revised 3rd edition of American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R). It is not included in the current edition of DSM; i.e., DSM-IV, and so it is now no more considered to be an appropriate diagnostic category. However, the condition is still studied by researchers for academic and medical purposes.

As is the case with any other psychological condition, SPD is diagnosed by a psychotherapist by asking a patient various questions relating to his or her mental state as well as the reasons for various actions and behavior. Certain blood tests may be conducted to see if there are any hormonal or chemical imbalances. CT scans may be carried out to check whether there are any abnormalities in the anatomy of the brain which might indicate the cause of this violent or brutal behavior.

Sadistic Personality Disorder Diagnostic Criteria

The DSM-III-R criteria for diagnosing SPD are presented below:

  1. A pervasive model of cruel, aggressive and demeaning behavior that begins by early adulthood, and indicated by repeated occurrence of a minimum of 4 of the following:
  • Have used violence or physical cruelty for establishing dominance within a relationship, not just to achieve some non-interpersonal goal, like striking someone for robbing him or her
  • Humiliated or demeaned people in front of others
  • Has behaved with someone under his supervision unusually harshly in the name of discipline (for example, a child, prisoner, student or patient)
  • Takes pleasure in or is amused by the physical or psychological suffering of others, even including animals
  • Lied to other people for causing harm or inflicting pain on them, not just to achieve a definite goal
  • Uses intimidation or terror to make other people do things that he or she wants them to do
  • Restricting the autonomy of the other people within a close relationship
  • Has a fascination towards violence, martial arts, weapons, injuries, and/or torture
  1. The behavioral patterns listed under A have not been directed towards only one person and has not been solely done for achieving sexual arousal (i.e., sexual sadism).

 

Sadistic Personality Disorder Differential Diagnosis

There are a number of psychological disorders whose symptoms may overlap with that of SPD. Hence, it is necessary that a clinician differentiates it from such conditions in order to come up with a precise diagnosis. The differential diagnoses of SPD include isolating its symptoms from those of disorders like:

  • Schizoid Personality Disorder
  • Paranoid Personality Disorder
  • Antisocial Personality Disorder
  • Schizotypal Personality Disorder
  • Personality changes caused by some general medical condition
  • Symptoms that might develop in connection with chronic substance abuse

Sadistic Personality Disorder Treatment

Treating an SPD patient might take a long time. It is necessary to change the personality traits like beliefs, coping mechanisms, and behavior patterns which take several years to form, and may change only very slowly. The changes normally occur in some predictable sequence, and various treatment modalities are required to facilitate them.

Symptoms such as depression or anxiety can be quickly relieved by reducing stress in the immediate environment. Behaviors, such as aggression, recklessness, lack of assertiveness, social isolation, temper outbursts, or violent spells can be changed gradually over a few months. Behavior modification therapy and group therapy, sometimes within a day care model or in designed residential settings, can prove to be effective. Participation in family therapy or various self-help groups can also assist an individual to change the socially undesirable behavioral patterns.

Psychotherapy and Counseling

Although treatment might differ from one personality disorder type to another, certain general principles do apply to all. Family members might be able to act in ways which can either diminish or reinforce the difficult thoughts or behavior of a patient. Hence, their thoughtful involvement often becomes necessary in aiding the patient to a smooth recovery.

Pharmacotherapy

Medications and drugs might have limited benefits. They can also be used for abuse or suicide attempts. Drugs can be moderately effective when symptoms of depression and anxiety occur alongside the sadistic mentality. Self-examination is required alongside prescription drugs to facilitate overall healing.

Sadistic Personality Disorder Prognosis

The outcome of SPD is generally positive with proper treatment. However, it might take several years for the effects of treatment to become apparent. Psychological disorders take time to heal, and re-evaluation of the condition of patients is necessary from time to time to chart the rate of progress. Treatment procedures might not exactly be the same for every patient as the needs of each and every individual might be different.

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