'Madness without delirium', 'moral
insanity' - these are just two of the terms that had been used until the late
1800s to describe the personality without a conscience, the personality with a
lack of social responsiveness. The term 'psychopath' was first coined by a
German clinician and since then has been used as the description of the
criminal with violent, unstable behaviour.
The term 'sociopath', first used in the
1930s, is considered by some to be a synonym for psychopath, by others to
describe an individual with behaviours which are perhaps less extreme. Today,
the same definitions and uses of the terms 'psychopath' and 'psychopathy' are
not accepted by all researchers. Most agree that psychopathy is a
personality disorder characterized by a pattern of disregard for the
feelings of others and often the rules of society.
The psychopath has a lack of
empathy and lack of remorse as well as very shallow
emotions. However there is no consensus about the symptom criteria for
psychopathy, and no psychiatric or psychological organization has sanctioned a
diagnosis of 'psychopathy'. Many researchers do not consider the terms antisocial
personality disorder (ASPD) and psychopathy as being synonymous.
ASPD refers to broad behavioral patterns
based on clinical observation, whereas psychopathy assesses character as well
as behavior.
The definition of ASPD is so broad
that it is estimated that between 50-80% of male inmates qualify as
meeting its criteria whereas, Hare estimates that only 11-25% of
male inmates meet the criteria for psychopathy.
To make the understanding of these two
terms even more confusing, the current edition of the American Psychiatric
Association’s Diagnostic and Statistical Manual of Mental Disorders Text
Revision (DSM-IV-TR), published in 2000 describes antisocial personality
disorder (ASPD), which is characterized by a long-standing history of
criminal and often physically aggressive behavior and refers to it as synonymous
with psychopathy. Much research, however, shows that measures of psychopathy
and ASPD overlap only moderately.
The characteristics of the psychopathic
personality was first described systematically by Medical College of Georgia
psychiatrist Hervey M. Cleckley in 1941 who described psychopathy as
consisting of a specific set of personality traits and behaviors. According to
Cleckley, a psychopath was superficially charming, tending to make a good first
impression on others and often striking observers as remarkably normal.
This disarming presentation hides the
reality of the psychopathic individual who is self-centered, dishonest and
undependable and will, at times, engage in irresponsible behavior for no
apparent reason other than the sheer fun of it. The psychopath is devoid
of guilt, empathy and love and will have only casual and callous interpersonal
and romantic relationships. They may offer excuses for their reckless actions
blaming others, are often impulsive and rarely learn from their mistakes or
benefit from negative feedback.
With this definition in mind,
psychopaths seem overrepresented in prisons, many studies indicating that as
many as 25 percent of inmates meet the diagnostic criteria for
psychopathy. But other research also suggests that a sizable number of
psychopaths may be walking among us in everyday life. There may actually exist
'successful psychopaths', people who attain prominent positions in society,
such as politics, business and entertainment. Most psychopaths are male and the
'condition' of psychopathy is present in both Western and non-Western cultures.
As recently as the mid-1970s,
almost 80 percent of convicted felons in the United States were being
diagnosed as sociopaths/psychopaths. In 1980, psychologist Robert Hare of
the University of British Columbia devised the Hare Psychopathy
Checklist (revised five years later and now known as the PCL-R) which has
become a standard ratings tool most often used in forensic settings to
assess psychopathy, using a forty point scale. Using the PCL-R, one study
suggested that 1-2% of the general US population score high enough to
be considered potential psychopaths.
There is little evidence of a cure or
effective treatment for psychopathy. No medications can instill empathy, and
psychopaths who undergo traditional talk therapy often simply become more
adept at manipulating others and more likely to commit crime.
According to Dr. Hare, psychopathy stems
from as yet unconfirmed 'genetic neurological predispositions and as yet
unconfirmed social factors in upbringing'. Although the term 'psychopath' is
not officially used in diagnostic manuals (DSM-IV), it is still used by many mental
health professionals and by the general public as well as by the press and
in fictional portrayals (ex Hannibal Lecter).
Although psychopathy is associated with
and in some cases is defined by conduct problems, criminality or violence, many
psychopaths are not violent, and psychopaths are, despite the similar names,
rarely psychotic.
University of British Columbia, Vancouver, Canada |
Unfortunately, the label of 'psychopath'
has both political and social implications. By definition, a psychopath is an
individual who is likely beyond rehabilitation - today, an accusation which is
'politically incorrect'.
In the United States, high PCL-R
scores have been used as an argument to support the death-penalty. In the UK,
there is debate whether some individuals with personality disorders (such as
psychopaths) should be detained even if they haven't committed a crime.
The Hare Psychopathy Checklist,
Revised (PCL-R) is a clinical rating scale consisting of 20
items. Each of the items in the PCL-R is scored on a three-point scale
according to specific criteria through file information and an interview of the
patient. A value of 0 is assigned if the item does not apply, 1 if
it applies somewhat, and 2 if it fully applies.
Hannibal Lecter |
There are similarities or 'cross-overs'
with other psychiatric conditions, such as PCL-R Factors 1a and 1b being seen
also in narcissistic personality disorder and histrionic
personality disorder.
PCL-R Factors 2a and 2b are strongly
correlated to antisocial personality disorder as defined in the
DSM-IV.
The PCL-R was developed primarily as
an assessment for convicted criminals. As with any 'interview' device, the
quality of ratings may depend on how much background information is available,
whether the person being rated is honest as well as the objectivity of the
interviewer.
The Hare Psychopathy Checklist, Revised (PCL-R)
Factor 1: Personality 'Aggressive narcissism'
a. Glibness/superficial charm
b. Grandiose sense of self-worth
c. Pathological lying
d. Cunning/manipulative
e. Lack of remorse or guilt
f. Shallow affect (genuine emotion is short-lived and egocentric)
g. Callousness; lack of empathy
h. Failure to accept responsibility for own actions
b. Grandiose sense of self-worth
c. Pathological lying
d. Cunning/manipulative
e. Lack of remorse or guilt
f. Shallow affect (genuine emotion is short-lived and egocentric)
g. Callousness; lack of empathy
h. Failure to accept responsibility for own actions
Factor 2: Case history 'Socially deviant lifestyle'
a. Need for stimulation/proneness to boredom
b. Parasitic lifestyle
c. Poor behavioral control
d. Lack of realistic long-term goals
e. Impulsivity
f. Irresponsibility
g. Juvenile delinquency
h. Early behavior problems
i. Revocation of conditional release
Traits not correlated with either factor
a. Promiscuous sexual behavior
b.Many short-term marital relationships
c. Criminal versatility
d. Acquired behavioural sociopathy/sociological conditioning (Item 21(d): a newly identified trait i.e. a person relying on sociological strategies and tricks to deceive)
The PCL-R is referred to by some as the
'gold standard' for assessing psychopathy. Thirty out of a maximum score of 40
is recommended as the cut-off for the label of psychopathy (Hare, 2003),
although there is little or no scientific support for this as a particular
break point.
In research, a cut-off score of 25 is
sometimes used. This threshold varies between jurisdictions as well -
the UK has used a cut-off of 25 rather than the 30 used in the US.
Other studies attempt to describe
'psychopaths' according to their major characteristics, separating them into 4
groups (primary and secondary first described by Cleckley in 1941):
Primary psychopaths do not
respond to punishment, apprehension, stress, or disapproval. They are able to
inhibit their antisocial impulses most of the time, not because of conscience,
but 'because it suits their purpose at the time'. Words do not seem to have the
same meaning for them as they do for the general population. At times, it seems
they are unable to grasp the meaning of their own words ('semantic aphasia').
They don't follow any life plan and are incapable of experiencing any genuine
emotion.
Secondary psychopaths are
risk-takers but are also more likely to be stress-reactive, worriers, and
guilt-prone. They expose themselves to more stress than the average person and
are as vulnerable to stress as the average person. They are daring,
adventurous, unconventional people who began playing by their own rules early
in life. They are strongly driven by a desire to escape or avoid pain, but are
unable to resist temptation. As their anxiety increases toward some forbidden
object, so does their attraction to it. They live their lives by the lure
of temptation.
Both primary and secondary psychopaths
can be subdivided into:
Distempered psychopaths fly into a rage or frenzy more easily and more often than other subtypes. Their frenzy will resemble an epileptic fit.
They are also usually men with incredibly strong sex drives, capable of astonishing feats of sexual energy, and seemingly obsessed by sexual urges during a large part of their waking lives. Powerful cravings also seem to be in their character, cravings such as drug addiction, kleptomania, pedophilia, any illicit or illegal indulgence. They like the endorphin 'high' of excitement and risk-taking (see post: Your Personal Narcotic).
Distempered psychopaths fly into a rage or frenzy more easily and more often than other subtypes. Their frenzy will resemble an epileptic fit.
They are also usually men with incredibly strong sex drives, capable of astonishing feats of sexual energy, and seemingly obsessed by sexual urges during a large part of their waking lives. Powerful cravings also seem to be in their character, cravings such as drug addiction, kleptomania, pedophilia, any illicit or illegal indulgence. They like the endorphin 'high' of excitement and risk-taking (see post: Your Personal Narcotic).
Charismatic Psychopaths are
charming, attractive liars. They are usually gifted at some talent or another,
and they use it to their advantage in manipulating others. They are
fast-talkers and possess an almost demonic ability to persuade others out of
everything they own, even their lives. Leaders of religious sects or cults (see
post: The Reverend Jim Jones)
might be psychopaths if they lead their followers to their deaths. This
subtype often comes to believe in their own fictions and are irresistible.
Popular misconceptions surrounding
psychopathy persist (possibly due to the condition's depiction in the media):
1. All psychopaths are violent - not true.
1. All psychopaths are violent - not true.
Psychopathy is a risk factor for future
physical and sexual violence and at least some serial killers—Ted Bundy,John
Wayne Gacy and Dennis Rader, the infamous “BTK” (Bind, Torture, Kill)
murderer—have manifested numerous psychopathic traits, including superficial
charm and a profound absence of guilt and empathy.
Most psychopaths, however, are not
violent, and most violent people are not psychopaths. In the days following the
horrific Virginia Tech shootings of April 16, 2007, many newspaper commentators
described the killer, Seung-Hui Cho, as 'psychopathic'. Yet Cho exhibited
few traits of psychopathy. Those who knew him described him as markedly shy,
withdrawn and peculiar.
Seung-Hui Cho |
2. All psychopaths are psychotic - not true.
In contrast to people with psychotic disorders, such as
schizophrenia, who often lose contact with reality, Psychopaths are almost
always rational in contrast to people with psychotic disorders (ex
schizophrenia) who often lose contact with reality.
The psychopath is well aware that his
ill-advised or illegal actions are wrong in the eyes of society but shrug off
these concerns. Some serial killers referred to by the media as psychopathic,
such as Charles Manson (see post: Death Cults) and David Berkowitz, displayed
striking features of psychosis rather than psychopathy.
Charles Manson |
For example, Manson claimed to be the
reincarnation of Jesus Christ, and Berkowitz believed he was receiving commands
from his neighbor Sam Carr’s dog (hence his adopted nickname 'Son of Sam').
3. Psychopathy is untreatable - not necessarily true.
Psychopaths are often unmotivated to seek treatment but some studies suggest that psychopaths may benefit as much as non-psychopaths from psychological treatment. Even if the core personality traits of psychopaths are exceedingly difficult to change, their criminal behaviors may prove more amenable to treatment.
Is there a difference between
psychopathy and sociopathy? Are psychopaths and sociopaths two different
disorders?
Some literature says that these two
conditions are similar yet somewhat different. Some studies place the
prevalence of 'sociopathy' at 4% in our society. This compares with a
prevalence for anorexic eating disorders of 3.43% (nearly
epidemic); schizophrenia occurs in only about 1% of the population;
the rate of colon cancer in the United States, considered 'alarmingly high' is
about 40 per 100,000 - one hundred times lower than the rate of antisocial
personality.
The high incidence of sociopathy in
western (and likely, every) modern society has a profound effect on the rest of
us who must live with them or, at least, have them live among us.
Most people, however, know nothing about this disorder and, if they do,
they think only in terms of violent psychopathy - murderers, serial killers,
mass murderers - people who are conspicuous, who break the law and who, if
caught, will be imprisoned, perhaps even executed by our legal system.
The following, according to one article, is a comparison of the characteristics of the psychopath and the sociopath.
Psychopath Sociopath
Social relationships
unable to maintain normal relationships
appear normal in relationships Tendency to violence yes yes
Behaviour erratic controlled
Suffers from antisocial personality disorder antisocial personality disorder
Criminal behaviour erratic-leave clues and evidence well-planned-clues rarely left
Behaviour erratic controlled
Suffers from antisocial personality disorder antisocial personality disorder
Criminal behaviour erratic-leave clues and evidence well-planned-clues rarely left
ASPD? |
Sociopaths, in contrast, can be
obsessively organized and normal in their social relationships and caring
towards their parents. A sociopath would likely live an outwardly normal life
in a regular neighborhood and appear to blend in well with society.
Psychopaths are often unable to hold down a
steady job and house whereas sociopaths often have very
successful careers and try to make others like and trust them.
The sociopath is able to understand
human emotions quite well but is unable to experience them. This allows the
sociopath to be master manipulators of human emotions.
Violence by a psychopath is
erratic and unplanned and after the erratic act, psychopaths generally
leave behind a large trail of clues. On the other hand, sociopaths may
take years to plan acts of violence and revenge, making it difficult
to catch them. Each step in the violent act of the sociopath is carefully
planned, their crime often undetected.
Psychiatrists often don't distinguish
between psychopaths and sociopaths but rather label a person with antisocial
personality disorder (ASPD) with, perhaps the subclassification of 'sociopath'
(if their mental condition is a result of mainly social conditions such as
abuse during childhood) and 'psychopath' (if the condition is mainly
congenital).
If there are true differences between
these two 'conditions' then there certainly are similarities as well.
According to some therapists, both
sociopaths and psychopaths face medical disorders that can be treated or
alleviated if properly diagnosed, the treatment involving both psychotherapy as
well as proper medication.
In both situations, signs of the disorder begin to establish and surface at around fifteen years of age. The presenting symptom may be excessive cruelty to animals followed by lack of conscience, remorse or guilt for hurtful actions to others later on stage.
In both situations, signs of the disorder begin to establish and surface at around fifteen years of age. The presenting symptom may be excessive cruelty to animals followed by lack of conscience, remorse or guilt for hurtful actions to others later on stage.
There may be an intellectual
understanding of appropriate social behaviour but no emotional response to the
actions of others.
Psychopaths (perhaps the more severe
form of the same disorder?) may also face an inability to form genuine
relationships, and may show inappropriate or out of proportion reaction to
perceived negligence.
But why do these people exist? Is their
behaviour an illness/a disease? Can this type of murderously depraved behaviour
be biologically based?
There is evidence that problems in brain
structure and chemistry do play a part. Most experts agree that there is no
neurological 'litmus test' for psychopathy. At King’s College London,
scientists claim to have found the strongest evidence yet that psychopaths have
abnormalities in key areas of their 'social brains'. The researchers looked at
MRI brain scans of 44 male violent offenders (murderers and rapists), 17
fitting the diagnosis for psychopathy.
The prisoners with psychopathic traits
had significantly smaller amounts of grey matter in regions associated with
processing 'empathy, moral reasoning and 'self-conscious' emotions, such as
guilt and embarrassment'. Other studies have implicated abnormalities in the
amygdala (the area associated with aggression), lesions in the orbitofrontal
cortex as well as in the white matter connecting the two brain regions.
Genetics may also play a role. One gene
in particular has been implicated (MAO- A), which produces an enzyme that
breaks down serotonin, a neurotransmitter which affects mood and can have a
calming effect.
Named the 'warrior gene', it has been
theorized that the calming effects of serotonin may not always be effective in
people born with a variant of this gene. Some researchers postulate that the
brains of psychopaths may be wired for rewards.
Brain scans show that people with high
levels of 'impulsive antisociality' show greater activity in parts of the brain
related to anticipating and expecting rewards. If those rewards don’t come
nearly as frequently as expected, the psychopath becomes more aggressive, more
frustrated and more alienated toward the world.
Other studies suggest psychopaths’
brains have an enhanced ability to sense certain emotions — in particular,
fear. They seem better able to pick up cues of vulnerability or weakness,
making them, in a sense, a natural-born predator.
A Man With the 'Warrior Gene'? |
Certainly in modern times (and probably
throughout human history), psychopaths/sociopaths have been tormenting our
societies.
During the Second World War, German Nazi
and Japanese military physicians carried out cruel 'experiments and research'
on prisoners, documenting their findings in scientific fashion for the purpose
of 'discovery' and 'curiosity'.
At Auschwitz, under the direction
of Dr. Eduard Wirths, selected inmates were subjected to various
experiments which were supposedly designed to help German military personnel in
combat situations, to aid in the recovery of military personnel that had been
injured, and to advance the racial ideology backed by the Third Reich.
Unit 731 was a biological and
chemical warfare research and development unit of the Imperial Japanese
Army that undertook lethal human experimentation during the Second
Sino-Japanese War (1937–1945) followed by World War II. This 'medical' unit was
responsible for some of the most notorious war crimes carried out by Japanese
personnel.
The atrocities committed by the
commander Shiro Ishii (see post: Death by Physician) and others under his command
in Unit 731 included alive and awake dissection of prisoners (including
pregnant women, impregnated by the doctors themselves) and amputation then
reattachment of limbs to other parts of the victim's body.
Some prisoners had parts of their bodies
frozen and thawed to study the resulting untreated gangrene. Some victims were
used as living test cases for grenades and flame throwers. Others were injected
with strains of diseases (disguised as 'vaccinations') to study their
effects.
Male and female prisoners were deliberately infected with syphilis and gonorrhea through rape, then 'study' of their disease carried out.
Male and female prisoners were deliberately infected with syphilis and gonorrhea through rape, then 'study' of their disease carried out.
Unit 731 'Experiments' |
More recent, in 2011 and 2012, are the
cases of Canadian Luka Magnotta and Norwegian Anders Breivik.
Nicknamed the one newspaper as the cannibal
killer, Luka Magnotta (not his real name but rather one of several aliases) was
said to have been inspired by a Jack the Ripper-style slaughter video game
starring Christopher Walken.
Walken played a cop named Vince Magnotta
in the 1996 game Ripper. Luka, a 29 year old gay porn 'star', adopted the
same surname when he changed his name from Eric Newman in 2006.
The game starts with emails sent to a
newspaper from a serial killer addicted to butchering his victims. Luka
Magnotta allegedly murdered his Chinese boyfriend, Jun Lin, with an ice
pick in his Montreal apartment then dismembered the body, mailing one foot and
one hand to two federal Canadian political parties and the other foot and hand
to two private schools in Vancouver. The torso of his victim was discovered in
a dumpster near his apartment.
On July 1, 2012, Canada Day (the country's national
holiday), a severed head was discovered in a Montreal urban park.
Magnotta fled Canada and, after an
international alert, was arrested in Berlin and returned to Canada. A
few years back, Magnotta posted a video on You-Tube of footage of him
carrying out strangulation and suffocation of several kittens.
Magnotta is awaiting psychiatric
assessment and trial but has already submitted a plea of not guilty on murder
charges.
Another modern-day (possible) psychopath
is the anti-Islam militant Anders Behring Breivik arrested in Norway
for the killing of 77 people on July 22, 2011.
Breivik had admitted (with pride) to the
bombing of the government’s headquarters in Oslo in July, killing eight
people, before gunning down 69 and injuring a further 242 (all victims mostly
teenagers), at a summer camp of the ruling Labour Party.
He however, denied criminal guilt
and subjected the country to a trial during which the court had to rule on both
his guilt, and his sanity. Breivik attempted to use the trial as a
microphone for his ideology, keeping Europe 'white' and free from Islam.
The question of guilt was not an issue
as he admitted to the murders but it was Breivik's sanity which had been, from
the outset, the central question the court was obliged to answer. A number of
forensic and prison psychiatrists had told the court that they believed that
Breivik was not psychotic and therefore accountable for his actions.
However two people (the authors of the
first psychiatric assessment) disagreed, stating that the man was psychotic at
the time of his crimes and that he suffered from paranoid schizophrenia.
Prosecutor Svein Holden stated that,
given there were still doubts about his insanity, Breivik should be placed in
psychiatric care and not sent to prison. Breivik himself called
psychiatric care 'a fate worse than death'. If convicted of murder as a sane
individual, Breivik would face a maximum prison sentence of 21 years under
Norwegian law. Commitment to psychiatric care would mean Breivik could be
confined for a long time, perhaps for the rest of his life. The legal system in
Norway is scheduled to make a decision in July or August 2012.
These are all cases of murderous
individuals in modern times.
But were the Nazi doctors in the German
concentration camps and the Japanese doctors of Unit 731 true psychopaths? Or
were these men simply being led along by 'group think' or 'crowd
psychology' (see post: The Demagogues-How Do
They Do It?). Would they have behaved in a similar way if there had been no
war?
Luka Magnotta certainly seems to fit the
criteria for a psychopath. His psychiatric assessment is pending as of June
2012.
Anders Breivik had a well thought
out plan but allowed himself to be easily caught. At this point in time, there
does not seem to be full agreement as to whether this man is sane or not,
whether he is a true psychopath or really psychotic.
Finally, is there really a difference
between a psychopath and a sociopath? Perhaps one is only a more extreme form
of the other.
And are these two disorders (psychopathy
and sociopathy) really different presentations of 'antisocial personality
disorder' as defined in the DSM-IV?
More precise definitions may possibly be
helpful in treatment for the more extreme cases or may even signal that any
attempt at treatment or rehabilitation would be futile.
But for the population threatened by
these individuals, for the victims of their crimes, definition is, more often
irrelevant.
For an interesting discussion on the absence of empathy ( a hallmark of the psychopath), click on the link below.
*Psychopathy and sociopathy: subjects of research for the novel Whip the Dogs - Amazon Kindle;
The Tao of the Thirteenth God - Amazon Kindle.
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