To respond to your question, Joel, I think that Tony's alleged impulse control with the crack addicts is far more related to his survival instincts and the presence of A.J. He sees the proximity of the crackhead's gun and knows that he might not be able to get to his own piece before he gets blown away. He also realizes that A.J. could be a casualty. This situation is a Darwinian street scene where Tony's therapy has little relevance. Nevertheless, over the four years of the show, we have a bit of evidence that the therapy may be helping him. While what your friend says is true about sociopaths, we'd be hard-pressed to squeeze Tony into that category. He has far too much concern for others (e.g., Meadow) and has an active conscience (e.g., feeling responsible for Gloria's suicide).