Monday, 21 February 2011

What is a Psychopath?

Psychopaths are a natural phenomenon that exists at a frequency that confers an evolutionary advantage.  There are various definitions of a psychopath, and some attempts to separate the terms psychopath and sociopath.  I use both terms interchangeably.  The trouble I have with any definition is that it is heavily weighted by the context in which the diagnostic criteria have been arrived at.  Dr Robert Hare is perhaps the most famous clinician associated with the diagnosis and his experience is typical - the psychopaths that sparked his interest and, more importantly, informed his diagnostic criteria, were all in prison.
I haven't read of any weighty criticism of this - basing criteria for a psychological diagnosis on a very obviously skewed sample.  I guess it is understandable because society only really has motivation to diagnose and understand people who are different when they impact society - and most diagnoses are court-ordered for offenders.
I see psychopathy as being a spectrum (of thought pattern), and for the diagnosis and understanding of it to be critically based on criminal behaviour is disingenuous at best.
The definitive traits of the psychopath certainly make them more likely to be a criminal, but that is hardly the full story, just as not all young black men in ghettos are criminals.  We live in a scientific age where we can analyse genes and image brains as they function - more research is needed to catch budding psychopaths when they are young so that behavioral treatments can be given as soon as possible.  The evidence so far is that genes and environment play a part in the development of a psychopathic personality.  Given the right environment, I have no doubt that those with psychopathic tendencies have the potential to be not just honest and productive members of society, but valued for contributions that an empath simply couldn't provide.

So what are the diagnostic criteria I consider essential?  At a neurological level, there are noted differences in the brain structure of psychopaths - though care should be taken that physical criteria like this are also not simply associated with criminal tendencies, such as low impulse control.  I think essential to a diagnosis would be a lack of empathy and remorse/guilt.  There is also a lack of normal physiological response to usually emotive words - a psychopath would likely fail the Voight-Kampff test.

Further than that, it seems to me that there is also a lack of societal bonds - social situations are learned and used to form consciously decided impressions, and there is an instinctive feeling that the rules of society do not apply to them.

I expect to still be alive when genome sequencing and neurophysiology scans become routine for the richer half of the populations of the western world.  This will advance the understanding of many psychological diagnoses to a level we can only dream of today.  The only question is whether society will see it as a manageable neurodiversity, or as a disorder that needs to be eradicated (strong genetic tendency = abortion?).


Anonymous said...

I see it as a spectrum, too. It's funny, really... And like the upcoming DSM, I don't see NPD as one that is so far removed. The only empathy challenged mental variations I exclude (that I know of) are the autistic and schizoids. With Aspbergers (AKA Autistic Psychopathy) having a vastly different mind-set and capability (or lack thereof) from me, and schizoids who, well, they're a numbed bunch, and that's about it.

What really amuses me is how we seem to categorize it. This is a common model, through commentary I've seen:

1. Psychopaths: All criminals, scary, murderous lot.

2. Sociopaths: Con-men, thieves, hired killers, mass manipulators

3. Antisocials: Petty crooks that don't care about others. Enjoys deviant lifestyles. Total jerks.

The reality of it though, through what I've seen recently is that there is no great divide. Psychopathy is basically a fun bag at a party. All bags share common gifts, and the others are sprinkled with variations. Some people who attend the part get the starburst candies and others get the M&Ms, but everyone got a card, a squirt gun, and a plastic necklace.

Some people though only got the three major ones, and the rest of their bag is basically barren. It doesn't make them any less psychopathic, though it may make them less likely to be the crazy, murderous lot.

Today's article at SW was interesting, because it showed definitive difference between low and high functioning. Without a shadow of a doubt, there apparently is one.

I thank my lucky stars that I was blessed with the higher functioning bit, yet, I suspect, if I wasn't, I probably wouldn't care, and it would be a moot point.

ResCogitans said...

yeah i didn't want to go into what would separate other related conditions, especially NPD. i think i see NPD as being always arrogant even if acting meekly would be a better tactic in a situation, caring what other people think (of them), and not being self aware. i think all 3 would have to be there for me to see someone as NPD as opposed to psychopathic.

a lot of type 3s at SPW recently, but also a couple of more thoughtful ones - though there have been a few posts recently that have been intelligent but have had more than a whiff of literary masturbation

you mean you wouldn't choose blissful ignorance? space out on soma? take the blue pill? frontal lobotomy? :)

< sigh> i was going to write a short fun piece about laughter, but had just read another bit of 'snakes in suits' and it had raised a few issues with me i wanted off my chest... < /sigh>

Anonymous said...

Literary masturbation... I can't help pleasuring myself with words, Res. It's an addiction for which there is no outreach! ;) The curse of someone who has enjoyed the warm and seductive touch of prose too many times.

NPD, to me, is different. I pretty much grew up with someone who was a textbook case. We are very different people, but the fundamental groundwork is there between is. No empathy, no remorse, no conscience, and no compassion.

Where it differs from there, it certainly changes and takes shape into a different beast. No doubt about it. A red rose and a white rose may have different hues, but both are still roses, with thorns and scents so similar.

I think people who like to claim to be Type 1's have a huge amount of pride. As if they are the Alpha Deviants or something. It's ridiculous. I won't name names, but I've seen it several times. It's as if the three types of the model all want to be what is above them, and those at the top need dick measuring contests to see who is the coldest mofo around.

Truth be told, I'm contemplating formal diagnosis. I've narrowed it down to two psychologists in my area who specialize in PDs. It would be nice to know where I actually stand through the eyes of a clinician, not the presumptions I have come to about myself, be they through facts or wishful thinking, if that is what it is. I intend to seek someone out to write a book on the subject, so knowing what I am will help me find who I need.

ResCogitans said...

so you want to be the new Sam Vaknin?
think about it carefully before getting a diagnosis - that will be permanent on your record...

also raises the tongue-in-cheek question i made - if prescribed medication would you take it? what happens if you refuse it and the psych thinks you may present a danger to yourself/society?

TBH i can't see any benefit from getting an official diagnosis unless the book is written and has an agreed publisher who recommends a diagnosis to use as publicity.

Anonymous said...

Oh heavens no... I don't want to be anything like him >.< A book more along the lines of, "Dr so and so and Mr Blank talk about higher functioning psychopathy, along with several others". Basically, the spectrum's eye view from non felons.

But yes, to do a book like that, a diagnosis would probably be required. And no, I'm not a danger to anyone at the moment, so I'm confident that wouldn't be an issue.

As far as my permanent record, I don't intend to work for the government in any way, so I don't see an issue.

ResCogitans said...

oh i see, a co-authored piece of literary masturbation, lol :p
you'll need a catchy title, any thoughts?

and you didn't answer the question...
if you don't want to change (and what's the treatment if you do!?), and therefore refuse any treatment (be it CBT or medication) then the psychologist is going to wonder why you are there. what's your plan - go in and tell them you need a diagnosis to get a book deal?

i still think set up the book deal first and only if that is moving forward get the diagnosis.

Anonymous said...

Good point.

Maybe it is for wont of understanding, from someone who has a lot of experience with PDs, and possibly psychopathy, you know? I can read articles, hear testimonials, share stories, et cetera, but sitting down with someone and getting the "inside scoop", for what, one or two $80 sessions, that would be nice.

And perhaps they would know of some surefire methods of impulse control, or anger channeling, or something.

The goal isn't to change myself or know myself, so much as it is to know how to wield myself better, if that makes sense...

ResCogitans said...

i can understand if i had low impulse control wanting to change that, and not seeing that as being an essential part of who i am...

Anonymous said...

Res, you remember that SW article the other day about the physical differences in the brain for psychopaths, and low/high functioning ones too, right?

I think I'm middle ground in that low/high functioning. I can be cautious and painstaking, and on the flip side, I can be totally out of control.

I used to be worse (violent) but not by much. I would be in prison still for some of the things I've done... Frankly, I haven't really calmed down, but what I have done is taken myself out of the situations where I am prone to cause harm. I spend very little time with friends or at bars, and live pretty isolated. I do like solitude to some extent, but I feel starved for human interaction and like to talk with people at work.

It's an odd situation, but I'm doing my best to stay off the radar.

ResCogitans said...

self control / free will is a tricky and complicated subject. certainly self awareness is important - if you can't see the behavioural pattern you can't change it - but how much can we change our impulse control? i think it is a slow process to effect any real change in impulse control, with CBT a valuable tool. i'm almost the polar opposite - i am so much in control that i sometimes think i may as well be a robot, that it is giving into the impulses that makes us human. i do not do impulsive crimes of passion, i am more the cold revenge type.

you are probably wise staying out of triggering situations, until you are more confident you can stay outa jail!

Zhawq said...


I love this article, your view on "our species", lol.

But you make two mistakes, and I can see why you make them: They stem from your mixing up the two labels, Psychopathy and Sociopathy.

The Psychopathy diagnosis is NOT based on behavior other than as an indicator of what goes on in the individual's psyche. Hare's criteria are based on our neuro-psychological differences from the normal population, whereas it is the DSM-IV (the one with ASPD all-in-one) that bases diagnosis on behavior ALONE and therefore also does not distinguish between psychopaths, people with ASPD and socioptahs.

That said, you write:

"The trouble I have with any definition is that it is heavily weighted by the context in which the diagnostic criteria have been arrived at."

Those criteria would be culture, no? That will always be the case. And that is why even though the psychopathy diagnosis takes it's basis on neuro-psychological factors in the individual, it is also biased because it serves a society who has no more religious scape goats to blame, so it takes the next in line like it's been doing since it started with throwing out the religious aristocracy, then the royal aristocracy, then it disarmed the military aristocracy, and now we have only the merchants and the slaves, and the last few aristocrats in spirit (I'll be blunt: That's us!).

I love what you say in this article. But I've spend some space on preaching my "learn the definitions!" pet hang up because I see it disrupting understanding again and again. And that's just too bad, because we need all the understanding we can gather, for we're alone like few humans will ever experience being alone....even as we communicate - when we're lucky (and can hear our thoughts through the mud throwing from the 'anonymous sociopath bad-ass wannabes).


Arh, sorry, ResCo, fever is messing with my self-control. Lol. And I tend to ramble,, rant! :D

ResCogitans said...

"The trouble I have with any definition is that it is heavily weighted by the context in which the diagnostic criteria have been arrived at."

Those criteria would be culture, no?

The next sentence after that gives the contextual bias i meant: "the psychopaths that... informed his [Hare's] diagnostic criteria, were all in prison."

TBH i didn't think there was a widely accepted difference between sociopathy and psychopathy - where have you got your definitions from? the DSM-V due for release in 2013 separates out "APD, Psychopathic type" (no mention of sociopathy).

BTW: as for "our species", i think you will not find me declaring anywhere (here, or on other blogs) that i am a sociopath/psychopath. the closest you will find is something like 'my thought processes are mostly sociopathic' or 'i can identify with many socio traits'. this post was written from a purely objective stance ;)

feel free to ramble/rant as you wish - always interesting to read :)

Zhawq said...

"Those criteria would be culture, no?"

It's always culture, yes. But even within culture there're larger or smaller sub-cultures.

"TBH i didn't think there was a widely accepted difference between sociopathy and psychopathy"

There are a few, depending on what 'sub-culture' you ask. The one I'm referring to is Hare's. His definitions make most sense to me, and they have the practicality of also being those most used by authorities and institutions I mostly get into contact with. That is, most researchers and clinical/forensic psychologists adhere to Hare's school of thought.

"the DSM-V due for release in 2013 separates out "APD, Psychopathic type" (no mention of sociopathy)."

Yes, and that is at least better than the mish mash we have now. I still personally use the notion that all three exist though.
Another thing also, DSM-V can easily be changed a couple more times before it comes out.

"i think you will not find me declaring anywhere (here, or on other blogs) that i am a sociopath/psychopath."

And I think you're right about that. ;)

"the closest you will find is something like 'my thought processes are mostly sociopathic' or 'i can identify with many socio traits'."

I see. Yes, I think I can understand that.

"Feel free to ramble/rant as you wish - always interesting to read :)"

Thanks, Res! ^L^,