Psychopathy - the mask of sanity that psychopaths wear
Normal and abnormal
The term "psychopath" is frequently used in the popular press and even by professionals in the field of psychology. The term is very often used for sensational purposes, in the sense of the definition given by the Concise Oxford English Dictionary of a psychopath: "a person suffering from chronic mental disorder with abnormal or violent social behaviour."
A.C. Grayling (in his 2001 book The Reason of Things) reminds us to be careful of such statement: "We have been taught (by Laing, Foucault and others) to be suspicious even of our best medical judgements about what is "normal" in the realm of mind, and we know that madness is not one thing but many."
The power that the image of the psychopath has over the popular imagination is captured well by Daniel Goleman in his great book Emotional Intelligence (Bloomsbury,1996), where he writes: "The cruelest of criminals, such as sadistic serial killers who delight in the suffering of their victims before they die, are the epitome of psychopathy."
Despite the power of the term to inflict fear and horror on people, it is not an uncontested concept and indeed, no longer even appears as a diagnosis in the DSM-III, the handbook of mental disorders published by the American Psychological Association (APA).
In the World Health Organisation's ICD-10 terms what was formerly known as psychopathy Dissocial (Antisocial) Personality Disorder.
However, many researchers disagree with these actions, most notably Robert D. Hare, whose Psychopathy Checklist-Revised (PCL-R) is still widely used in the field.
Definitions and controversies
The term "psychopathy" was used until 1980 "for a personality disorder characterized by an abnormal lack of empathy combined with strongly amoral conduct but masked by an ability to appear outwardly normal." (Wikipedia article on Psychopathy accessed on 1 February 2011).
The tendency these days is to separate sociopathy from psychopathy, and to call those who lack empathy sociopaths.
The distinction between the two terms also seems to hinge on the origin of the psychopatholgy. Psychopathy seems to have a physiological basis while sociopathy seems to have more of an environmental basis.
The impllication of this is that psychopaths are usually born, not made, while sociopaths are made not born.
This would answer the question asked by Weblog about how to become a psychopath - one cannot become a psychopath, one is born that way.
Who's looney now? The problems of definition
Non teneas aururn totum quod splendet ut aururn (Do not hold as gold all that shines as gold)
In his seminal work on psychopathy, The Mask of Sanity (1941), Hervey M. Cleckley illustrated the difficulty of defining madness with this story:
A millionaire notable for his eccentricity had an older and better balanced brother who, on numerous fitting occasions, exercised strong persuasion to bring him under psychiatric care. On receiving word that this wiser brother had been deserted immediately after the nuptial night by a famous lady of the theatre (on whom he had just settled a large fortune) and that the bride, furthermore, had, during the brief pseudoconnubial episode, remained stubbornly encased in tights, the younger hastened to dispatch this succinct and unanswerable telegram: WHO'S LOONEY NOW?
The problem for society, and for the families of people displaying the behaviour often labelled "psychopathic" is that they are often able to function at quite high levels of competence.
There are warning signs, however, and various tests for a physician or psychologist to use to determining the presence or absence of the pathology in the client/patient.
The tool most used by researchers into the syndrome is the Hare Psychopathy Checklist - revised (PCL-R) in which uses two major factors and two minor traits. Each major factor is in turn broken down into other indicators. The following are the factors of the LCL-R (it is important to note that the presence of one or more of these indicators does not necessarily indicate that the person exhibiting them is a psychopath - a qualified person would have to assess a person to establish the presence or absence of psychopathy):
Factor 1 Aggressive narcissism
Grandiose sense of self-worth
Lack of remorse or guilt
Callous/lack of empathy
Failure to accept responsibility for own actions
Factor 2 Socially deviant lifestyle
Need for stimulation/proneness to boredom
Poor behavioral control
Promiscuous sexual behavior
Lack of realistic, long-term goals
Early behavioral problems
Revocation of conditional release
Traits not correlated with either factor
Many short-term marital relationships
It would appear from research that psychopaths do not, contrary to the popular imagination, have an abnormal propensity to commit sexually-oriented murders.
Dr Robert Hare, the researcher who devised the PCL-R, has spent his whole professional life studying people labelled "psychopath" and has concluded that around 1% of the popoulation is clinically psychopathic, though only a small proportion of them actually become criminal. The vast majority of them naver commit any crime, and walk among us undetected.
Nevertheless they can, although not criminal, cause a great deal of hurt and psychological damage.
In his book Without Conscience (Simon and Schuster, 1993) Hare wrote:"Unlike psychotic individuals, psychopaths are rational and aware of what they are doing and why. Their behavior is the result of choice, freely exercised."
He stood a stranger in this breathing world: Psychopaths all around us
There was in him a vital scorn of all:
the worst had fall'n which could befall,
He stood a stranger in
this breathing world,
An erring spirit from another hurled;
thing of dark imaginings, that shaped
By choice the perils he by
- from "Lara" by Lord Byron.
There is in the popular imagination a horror, not unfounded, of the psychopath. The psychopath seems to lack understanding of others, indeed has a "vital scorn of all", which leads to unmentionable, unimaginable crimes.
The other source of the horror is that there appears to be no remedy, no rehabilitation possible for such people.
They feel no remorse, feel no empathy, and therefor thee is no logic to appealing to their "better natures" - they don't appear to have "better natures". No amount of talk therapy will ever bring them around - indeed, it seems only to make the condition worse as they learn to manipulate and confound their therapists.
When asked if there would ever be a cure for psychopathy, said:"The psychopath will say 'A cure for what?' I don't feel comfortable calling it a disease. Much of their behaviour, even the neurobiological patterns we observe, could be because they're using different strategies to get around the world. These strategies don't have to involve faulty wiring, just different wiring."
Perhaps the most scary thing about a psychopath is that he or she goes among us wearing "The Mask of Sanity."
The text and all images on this page, unless otherwise indicated, are by Tony McGregor who hereby asserts his copyright on the material. Should you wish to use any of the text or images feel free to do so with proper attribution and, if possible, a link back to this page. Thank you.
© Tony McGregor 2011