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Lewis HowesYour View On Psychopaths Will Never Be The Same After This | Dr. Patric Gagne
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CHAPTERS
- 0:00 – 1:26
Reframing “psychopath” stereotypes and the fear of being seen as a monster
Dr. Patric Gagne explains how media portrayals of psychopaths as serial killers shaped her early fear and confusion about herself. Lewis Howes sets up her background as someone diagnosed with sociopathy who later studied it academically and wrote a memoir about it.
- •Dr. Patric Gagne describes how negative TV stereotypes made her worry she might “wake up” and become violent despite not feeling evil
- •Lewis Howes introduces her as diagnosed and later earning a doctorate focused on sociopathy
- •The conversation frames the episode around understanding human behavior from both pro-social and antisocial perspectives
- 1:26 – 5:46
How emotions work: inherent emotions vs “social emotions” like empathy and guilt
Dr. Gagne argues that psychopaths can feel basic, inherent emotions but often struggle with social emotions that are typically learned through modeling. She describes recognizing early that she understood others’ feelings intellectually but didn’t experience the expected emotional resonance.
- •Dr. Gagne says psychopaths feel inherent emotions (like happiness and sadness) but struggle with social emotions (like empathy, remorse, guilt)
- •She describes how children typically learn empathy through modeling and relating to others’ experiences
- •She recounts noticing other kids (and her sister) had emotional skills she didn’t share
- •She distinguishes not caring emotionally about someone’s pain from wanting to cause pain
- 5:46 – 8:28
Why lying can become a coping mechanism—and why it can feel rewarding
Dr. Gagne describes learning to lie about feelings because telling the truth led to trouble and judgment from caregivers. She contrasts Lewis’s discomfort with lying with her own experience of feeling safer after successfully deceiving others about her emotions.
- •Dr. Gagne explains she learned to say she felt remorse even when she didn’t, to avoid consequences
- •She describes lying as internally rewarding because it created a sense of safety and relief
- •She challenges the assumption that lying always starts from “evil” motives, describing it as a coping strategy
- •She discusses the exhaustion of “shape-shifting” emotionally and later deciding to stop lying about emotions
- 8:28 – 13:05
Sociopath vs psychopath: clinical language, primary vs secondary psychopathy, and screening limits
Dr. Gagne explains that “sociopath” is clinically obsolete and outlines two categories of psychopathy: primary and secondary. She also critiques how common assessment tools focus heavily on prison populations, which she argues distorts prevalence estimates.
- •Dr. Gagne says “sociopath” and “psychopath” are often used interchangeably, though “sociopath” isn’t used clinically
- •She distinguishes primary psychopathy (biological, rare, described as untreatable) from secondary psychopathy (environmental, described as treatable)
- •She notes research uncertainty about biological mechanisms and mentions oxytocin as one research focus
- •She explains the PCL as a prison-oriented testing standard and argues this skews prevalence estimates
- •She says pediatric precursors (like conduct-related diagnoses) are treatable and preventable with screening and treatment
- 13:05 – 21:07
Inner-child compassion and challenging the idea that anyone is “irredeemable”
Lewis reflects on the book cover photo of Dr. Gagne as a child and connects it to compassion and healing through understanding childhood experiences. Dr. Gagne challenges stigmatizing language like “irredeemable,” asking when society decides a child becomes beyond help.
- •Lewis frames adult patterns as rooted in childhood experiences and highlights compassion for one’s younger self
- •Dr. Gagne questions when, developmentally, someone would be deemed “irredeemable”
- •She says remembering her own childhood loneliness helped her build a bridge toward empathy
- •She compares psychopathy stigma to only acknowledging “stage four” versions of a condition and ignoring earlier stages
- 21:07 – 30:22
Finding support, choosing honesty, and discovering the “container” role in therapy
Dr. Gagne describes how therapy began after she told her father and was fortunate to find a therapist willing and able to work with her. She explains why her limited emotional reactivity became an advantage in therapy work: she can hold space without making it about herself.
- •Dr. Gagne says meaningful support began when her father insisted she see a therapist
- •She describes committing to honesty about emotions and actions, even if it cost relationships
- •She argues empathy isn’t required to be a strong listener and “container” for someone’s feelings
- •She critiques the common reflex to stop others from crying, saying tears help regulate mood
- •She explains why being a therapist fit her: she wasn’t expected to perform emotional reactions and could focus on processing and problem-solving
- 30:22 – 34:56
Can psychopaths change? Resocialization, logic-based reframes, and why punishment fails
Dr. Gagne says change is possible through resocialization, using modeling and reinforcement strategies that work for antisocial individuals. She emphasizes that punishment tends to teach concealment rather than behavior change, and she describes a negotiation-based approach grounded in consequences and incentives.
- •Dr. Gagne says psychopaths can change through resocialization
- •She argues punishment doesn’t work well, especially for antisocial kids, and often teaches hiding behavior
- •She describes antisocial learning as starting “selfishly” and responding better to positive reinforcement
- •She illustrates a negotiation framework: focusing on what a behavior will cost the person rather than moralizing
- •She explains adult treatment reframes behavior around maintaining desired life outcomes (job, money, relationships)
- 34:56 – 44:06
Thrill-seeking, pressure release, and how “small” deviance can escalate
Lewis and Dr. Gagne compare childhood stealing and the role of remorse, fear, and consequences. Dr. Gagne describes “disciplined acts of deviance” as a way to release internal pressure, including breaking into homes for quiet and relief rather than theft—while acknowledging the potential for violence when pressure builds.
- •Lewis recounts stealing as a child and how being confronted triggered remorse and ended the behavior
- •Dr. Gagne describes feeling relief—not remorse—when forced to return stolen items, wanting help understanding the compulsion
- •She explains using repeated deviant acts as pressure relief to prevent a larger destructive act
- •She describes breaking into homes as chasing stillness and relief, not vandalism or stealing
- •She recounts an early incident of violence in first grade when pressure-release strategies failed
- 44:06 – 46:10
Awareness as the core of healing: linking trauma to behavior and learning to sit with emotion
Dr. Gagne argues that most change begins with awareness—seeing how present behaviors connect to past experiences and bodily states. The conversation expands into how people avoid emotion, how unprocessed trauma shows up elsewhere, and why “moving on” culture blocks nervous system regulation.
- •Dr. Gagne says “80% of the work is in awareness,” connecting trauma memories to present behaviors
- •She discusses how people use compulsions and addictions as “pressure release” when they lack emotional tools
- •Lewis shares how sports served as a release valve and how identity can form around these outlets
- •They discuss how modern speed, devices, and distraction reduce stillness needed for self-awareness
- •Dr. Gagne critiques cultural avoidance of grief and painful conversations, arguing the body stores unprocessed trauma
- 46:10 – 52:37
Owning the label, finding community, and replacing masking with “hyper honesty”
Dr. Gagne explains why she still uses the word “sociopath” for herself: it anchored her research journey and reduced isolation. She describes online communities for people with psychopathic traits and shares how dropping the mask—being unusually honest—reduced her claustrophobic pressure and destructive impulses.
- •Dr. Gagne says the label helped her feel less alone and gave language to her experience
- •She cautions against using psychopathy labels to justify harmful behavior
- •She describes communities where people discuss struggles without glorifying extreme violence
- •She explains that hiding her true self created emotional claustrophobia that drove acting out
- •She says hyper honesty and asking for support when dysregulated reduced her impulses over time
- 52:37 – 1:03:20
People-pleasing, love, and the “two containers” model for self-worth
Dr. Gagne says she can’t relate to people-pleasing and defines it as needing to make others happy to feel good about yourself. She reframes common romantic narratives as outsourcing self-esteem, then introduces a model of internal vs external “containers” to explain self-confidence and relational dynamics.
- •Dr. Gagne defines people-pleasing as needing others’ happiness to feel good about yourself
- •She contrasts her fear of hurting partners with neurotypical friends’ fear of abandonment
- •She argues “you complete me” thinking can turn relationships into self-esteem regulation rather than love
- •She presents two containers: an internal container (self-worth, self-confidence, regulation) and an external container (connection, partnership)
- •She says many relationships fail when one partner expects the other to fill their internal container
- 1:03:20 – 1:07:04
Building confidence in kids: boundaries, apologies, and making space for uncensored feelings
Lewis asks how parents can help children develop inner tools like self-confidence and emotional processing. Dr. Gagne emphasizes modeling, boundary-setting, normalizing apologies, and asking kids to describe their feelings in ways adults can contain without shutting them down.
- •Dr. Gagne says modeling matters more than lecturing because kids watch behavior
- •She highlights boundaries as a core demonstration of confidence and self-respect
- •She stresses modeling real apologies and notes many adults resist apologizing due to ego and fragile self-worth
- •She recommends asking children, “How does it feel when you feel?” and allowing uncensored answers
- •She warns that forcing “normal” emotional responses teaches kids their real feelings are wrong
- 1:07:04 – 1:29:42
Psychopaths vs narcissists vs borderline patterns: similar behaviors, different motivations
Dr. Gagne explains that destructive behaviors can look similar across psychopathy, narcissism, and borderline personality patterns, but motivations differ. She describes narcissism as driven by unprocessed shame and defends focusing on actions over intentions.
- •Dr. Gagne says behavior can look similar across diagnoses, but the motivations are different
- •She describes narcissism as fundamentally organized around shame, often masked by grandiosity and superiority
- •She describes psychopathic destructiveness as sometimes driven by trying to “force a feeling”
- •She describes borderline patterns as prioritizing connection so intensely that loss of love can feel unconsciously catastrophic
- •She criticizes the “it wasn’t my intention” defense, emphasizing outcomes over intent
- 1:29:42 – 1:38:35
Guilt, shame, and choosing a moral code without emotional “safety nets”
Lewis asks whether shame is ever useful and how someone without shame or guilt stays ethical. Dr. Gagne says she lacks shame as a feeling, relies instead on discipline and an internal philosophy, and describes how easy it can be to justify harmful “vigilante” behavior without those internal brakes.
- •Dr. Gagne says shame and guilt can be useful in moderation but harmful when overused
- •She says she can recognize wrongdoing intellectually without feeling shame
- •She explains that lacking guilt/shame makes discipline essential because consequences don’t deter her internally
- •She describes relying on an internal philosophy or moral code rather than emotion-based restraint
- •She recounts being drawn to “vigilante” actions and noticing how seductive justification can become
- 1:38:35 – 1:46:39
Spotting traits, asking better questions, and final “three truths” on life and awareness
Lewis asks how someone might spot a psychopath in dating or business, and Dr. Gagne discourages simplistic quizzes in favor of observing emotional affect and asking direct questions about feelings. The episode closes with her “three truths,” her view on manifestation-like thinking, and her definition of greatness as awareness.
- •Dr. Gagne says “fun questionnaires” aren’t reliable and warns against diagnosing only by behavior
- •She suggests focusing on emotional affect and asking, “How does it feel when you feel?” if honesty is possible
- •She gives three truths: limited emotion isn’t inherently evil; it’s what we do that matters; and “it’s already yours”
- •She connects “it’s already yours” to not internalizing failure and being willing to take risks
- •She defines greatness as awareness
