Sadistic Personality Disorder: Signs, Traits, & Treatment

What Is Sadistic Personality Disorder?

Originally, SPD was used to describe individuals who took sexual pleasure in causing pain to others. The term was expanded, however, to include those who simply took overall satisfactions and pleasure in the suffering of others.¹  Sadists take pleasure in the infliction of physical pain, emotional pain, and psychological pain. They intentionally cause personal harm in order to give themselves personal satisfaction.

While this disorder may reflect the desire to disrupt the norms of behavior, in ways that an individual diagnosed with Antisocial Personality Disorder(APD) might do, the key difference between SPS and APD is in the purpose of the behavior. Sadistic individuals harm others for their own emotional satisfaction and pleasure. Antisocial individuals engage in disruptive behaviors to achieve material gain or to be manipulative, deceitful, and cause harm to society or others.¹

Millon’s Subtypes of SPD

Just as there are variations in other personality disorders, Theodore Millon, a psychologist who specializes in personality disorders, determined that there were four unique subtypes of sadism that exist.² Each of these types reflect the temperament of the sadist.

According to Millon, the four subtypes of SPD include:

1. Spineless sadism: These individuals display avoidant features to their behavior. They are insecure and lack courage, but they use these shortcomings to fuel their false bravado, among others. They tend to seek out powerless victims on whom to inflict pain.
2. Tyrannical sadism: These individuals display negativistic features and are energized through the menacing and brutalization of others. They crave and abuse power over others and use words as weapons to get others to submit to them. They are destructive, inhumane, and unmerciful.
3. Enforcing sadism: These individuals exhibit dependent features of sadism and find ways to “rightfully” inflict pain on others. They couch their torment in efforts to maintain order in this world through professions such as law enforcement and management. They take roles that give them the power to have control over others as well as seek out and punish those who don’t follow the rules, whether the rules refer to the laws or organizational practices.
4. Explosive sadism: These individuals are reactive and explosive in their displays of sadistic behavior. They can “blow” in a heartbeat and will direct their fury and rage at those around them. It’s as if they have been keeping feelings of humiliation stored up over time, and then when the final straw arrives, they explode. Explosive sadists have been noted to feel contrition after their outbursts.

History of Sadistic Personality Disorder

SPD is a term whose origin goes back in history to the 18th century. A member of the French nobility, the Marquis de Sade, cruelly engaged in harming others for his own enjoyment. Later on,  von Krafft-Ebing used the Marquis’ name as inspiration in his development of the term, Sadistic Personality Disorder.³ When SPD was added to the DSM-III-R, it was included as a disorder that warranted further study.⁴ There was controversy over whether or not it could stand as its own disorder. A great deal of overlap was found between this disorder and other similar disorders.

Due to concerns regarding overlap and a lack of studies that supported the existence of SPD as a standalone disorder, it has been removed from the DSM. However, the traits related to the disorder and the disorder itself are still present in the literature today.¹ There was also concern that this disorder could potentially be used in court to take the blame away from a perpetrator who had done harm to others. However, due to the unique nature of this disorder and the infliction of harm on others purely for personal pleasure, professionals still consider and reference the disorder today.

Sadistic Personality Traits

The ways in which an individual exhibits traits of SPD can vary, but the primary focus of their behavior is to cause suffering for others or to be in a place to witness others’ suffering.

Common traits of SPD include:

• Hostility: This describes feelings of negativity, ill will, or aggression towards another.
• Inability to feel empathy: When most people see another person in pain, they identify with those feelings and understand how pain affects a person and want to help alleviate it. Sadistic individuals recognize that people are suffering, but they enjoy others’ pain.
• Inability to feel remorse: Guilt about wrongdoing is experienced by the majority of people, but sadists do not feel guilty or bad about the harm that they do.
• Viciousness: Sadists go for the jugular when given the chance. They don’t hold back in their criticism, sarcasm, or physical attacks on others even when given the chance or encouraged to do so by others around them.
• Enamored by violent video games/media: Sadists revel in playing video games that allow them to physically harm others and enjoy violence in movies, sports, and so on much more than the average person does.
• Lack of responsibility: Sadists do not take responsibility for the harm that they bring to others.

Sensitivity to Criticism & Vulnerability

Individuals with SPD are extremely sensitive to criticism from others. For them, holding power over others or controlling others is their primary motivation. When they receive criticism, it takes away the power they need. Being vulnerable with others is also avoided as they believe that revealing intimate pieces of information or their feelings is tantamount to yielding power to another.

Their need for control keeps them from allowing anyone to truly get close to them. For them, control and power are the drivers behind their rigid personal boundaries. If someone tries to get too close, they may use force to ensure that person is kept in their place. Using force and violence to maintain their boundaries doesn’t cause them guilt, only pleasure at the opportunity to do so.

Signs of a Sadistic Personality Disorder

The most telling sign of a sadistic person is the pleasure you see them take in another’s pain. One form of sadism is “everyday sadism,” and this reflects the behavior of subclinical sadists who enjoy trolling people on the internet or bullying people face-to-face. Some of the signs of both this form of sadism and SPD are the same.

Some warning signs of a sadistic personality may include:

• Harming animals or others: This refers to intentionally causing pain to another living creature.
• Fascination with violence or death: This may show up as an obsession with violent crimes or criminals who complete them.
• Inappropriate humor: They laugh at situations in which pain has been experienced and find humiliation of others a subject of mirth.
• Look for reasons to harm others: Sadists go out of their way and will invest energy into the opportunity to inflict pain.⁵
• Lack of affective empathy: Empathy implies feeling another person’s feelings in such a way as to identify with those feelings. Those with SPS may recognize how another person feels, but when they recognize suffering, they feel a sense of pleasure rather than pain.
• Lack of concern for others’ welfare: Altruism is considered a survival mechanism in that by helping others, we are increasing the likelihood that others will help us when we need it. Sadists do not have the drive to invest in another’s welfare and do not show the desire to help others in need.
• Makes fun of people who they see as physically weaker: Sadists take pleasure in others’ weakness, as sadism is often driven by the desire for power and control. Seeing someone weaker than them presents an easy target for sadistic abuse, whether it is laughter or physical punishment.
• Watches and shares videos of people being hurt: In addition to gaining pleasure from hurting people themselves, they also enjoy seeing people get hurt by others and may seek out sources of this online and also may share their finds with others.
• Encourages others to hurt people: Encouraging others to engage in causing harm, emotional or physical, to others.

Diagnosis Criteria of Sadistic Personality Disorder

The last time that SPD appeared in the DSM was in the DSM-III-R.⁴ The traits that were used as signifiers of this disorder differ from other similar personality disorders that reflected cruelty and aggression. Displays of clinically significant sadistic behavior typically begin by early adulthood.

An SPD diagnosis requires a consistent pattern of at least four of the following behaviors:

• Uses physical cruelty and/or violence to dominate others
• Intentionally humiliates or demeans others publicly
• Exerts extreme discipline for others under their control
• Finds pleasure from witnessing pain of others, both humans and animals
• Uses lies to inflict pain on others
• Intimidates and frightens others to get them to do what they want them to do
• Limits others’ autonomy through the exertion of extreme control
• Experiences fascination and an obsession with physical harm/violence

Possible Causes of Sadistic Personality Disorder

While many of us are horrified by stories of extreme sadism and torture of others, sadistic individuals enjoy these stories. Traits of SDP typically show up by the time a person is in their teens and before they reach young adulthood, but some signs may manifest earlier than that. There is not a single specific cause of SPD, but disruptive and disturbing events during the early stages of a child’s puberty may be responsible in many cases.

Sadistic Personality Disorder may be caused by:

• Abusive caregivers: When children are abused by the ones on whom they rely for care, it can create a confusing situation for them, and some may begin to equate abuse and humiliation as a bond.
• Physical abuse by others: This is a strong predictor of sadistic behavior.⁶ If a child is a victim of abuse, they recognize that causing pain to another gives power to the abuser. As they grow older, they may inflict violence on others as a means of taking back the power that had been taken from them by others.
• Exposure to violence: Children who are exposed to violence may be conditioned to take pleasure in another’s pain. Social learning can be a powerful tool and when children are learning that pain leads to someone else’s pleasure, they may model their own behavior on that.
• Neurochemical disruption in the brain: The brain chemistry may be impaired in the way it responds to sadistic behaviors in that the “feel good” neurotransmitters when witnessing others suffering.
• Engagement in vicarious violence: If children are allowed to engage in violent video games or witness others commit violent acts or torture others, they may be conditioned to take pleasure in the rewards (often power or “winning” a game) and this may contribute to an existing predisposition to sadistic behavior.
• Extreme poverty: When a child has experienced extreme scarcities in adequate food or other resources, this may contribute to internalized humiliation. As a way to cope with this inequity, they may choose to exert power and take pleasure in others’ suffering as they felt others did with them.
• Frequent personal failures: When children and young adolescents are unable to feel a sense of personal adequacy and self-efficacy, they may begin to fill the void through making others suffer humiliation or physical pain. It gives them a sense of power to cause others harm.
• Being bullied: If a child is continually bullied by others, both physically and psychologically, they may begin building up a desperate desire to cause others the pain that they have experienced at the hands of uncaring, by tormenting others. By inflicting hurt on others, they feel that this will give them the power that they lacked when they were younger.

Differentiation From Other Disorders

Sadistic Personality Disorder is similar in many ways to other personality disorders, which suggests the entrenched nature of the disorder. Using power over others isn’t unique to SPD, as individuals diagnosed with Antisocial Personality Disorder also have a goal to experience a sense of personal pleasure. It’s the act of causing pain that pleases the individual with SPD, not any material gain.

Antisocial Personality Disorder

The key traits of someone who suffers with Antisocial Personality Disorder (APD) involve a willingness to exploit others for their own gain, the lack of any feelings of regret or remorse for others, an inability to handle their anger, and disregard for social norms. Individuals diagnosed with APD also must have a history of behavioral issues, specifically conduct issues, from childhood or adolescence; this is not a necessary pattern among those with SPD.

While someone with SPD may also be engaged in exploitation of others and have no regret for the pain they cause, it is the suffering of the other person that fills their emotional needs. Hurting others is the ultimate goal of sadists, but hurting others is typically just a means to an end for those with APD.

Sexual Sadism Disorder

The key traits of someone with Sexual Sadism Disorder (SSD) include many of the same characteristics of the more general SPD. The infliction of pain on another is what gives both the sexual sadist and the general sadist a kick. However, the sexual sadist engages in these activities in order to gratify their sexual needs rather than for a more general sense of power. Sexual sadists may both fantasize about causing harm or actually causing harm to another in order to satisfy their needs.

For sadists, their true sense of satisfaction comes from either causing harm or witnessing harm being done to someone else.

Sadistic Personality Disorder Treatment

Treating any personality disorder is a challenging task. Unfortunately, the most difficult aspect of this task is convincing someone with a personality disorder to believe they have a need for treatment. The motivating factor to seek treatment may be related to legal troubles or relationship loss. However, because someone with SPD takes pleasure in seeing others suffer, they may take pleasure in being noncompliant with treatment if they go at all.

Due to some of the ways in which APD, SSD, and SPD manifest, it is important to determine the correct diagnosis in order to select the proper treatment. When SPD has been identified, the most effective methods of treatment include psychotropic medications and long-term psychotherapy.

Common treatment for sadistic personality disorder include:

Psychotherapy

There are several forms of therapy that are used in treating SPD:

• Behavior Therapy (BT): BT is useful in that it helps clients recognize the way that their sadistic behavior harms others and helps them reshape their problematic behavior.
• Cognitive Behavioral Therapy:  Cognitive behavioral therapy (CBT) is also recommended as it encourages the client to explore how their thoughts and reactions are connected to their behavior. Ideally, CBT will support a client’s efforts in changing their thinking and learning new ways of responding to events around them.
• Dialectical Behavioral Therapy (DBT): Dialectical behavior therapy (DBT) can also be helpful through its focus on mindfulness and learning how to regulate your thoughts.

While there are ways that therapy can support changes in thought patterns and behavior, clients must be willing to stick with the treatment protocol and follow through on homework assignments and practice sessions as they learn the necessary skills to reduce their sadistic behaviors.

In regard to empathy and those with SPD, it is important to bear in mind that while sadistic people do not care about others’ feelings, they do cognitively recognize them. Psychotherapy may help these individuals learn to respond to another’s suffering with concern and care rather than pleasure.

Medications

Due to the lack of knowledge about the specific cause of SPD, there is not one specific psychopharmacological treatment that works to cure it. Taking medications that help with depression may have some efficacy for individuals with SPD who also have symptoms of depression; the same is true of medications designed to minimize anxiety. When individuals with SPD are better able to manage anxiety or stress, this may help minimize the disruption caused by the disorder.

How to Find Professional Help

If you or someone you know exhibits symptoms of SPD, finding effective assistance can be of great benefit. Speaking to your medical doctor for a referral to someone who specializes in personality disorders is one avenue in seeking professional help. You might want to explore an online therapist directory where you can search for specializations and treatment modalities; some individuals prefer face-to-face care and others might prefer working with an online psychiatrist.

Make sure you know what’s important when finding a therapist when you begin your search. In addition, you will want to review your healthcare policy so that you are aware of the coverage regarding insurance options; some practitioners provide sliding scales to those who have limited or no mental healthcare coverage.

In My Experience

In my experience, awareness of a personality disorder is the first step to improving one’s outcome. Unfortunately, the presence of everyday sadism seems more visible now that individuals can express their sadistic tendencies through increasingly violent video games, online sharing of sadistic acts, and other avenues. Recognizing when your own thoughts or feelings in response to another’s suffering are reflecting your own pleasure in another’s pain is important and a key to addressing these feelings before they lead to more dangerous behaviors. Cognitive behavioral therapy and dialectical behavior therapy are both effective treatments in changing response to unsettling or triggering events. By seeking help, or encouraging someone to seek help, when sadistic impulses first become a problem is the best way to ensure that treatment is successful.