Do you know a psychopath? You probably do, but maybe you just don’t know it.

Psychopathy is a popular culture construct, not recognized by the DSM, used to describe predatory and dangerous individuals. Assessments of psychopathy characteristics are widely used in criminal justice settings although most people labeled as psychopaths are not violent, and despite the name, they are rarely psychotic.

We live with psychopaths, work with them, and sometimes date them. Their ability to mask an internal ascetic personality structure is uncanny. Externally, psychopaths create a façade of desirability and exemplify many positive character traits.

If you were asked to describe your best friend, what would you say?

- Charming

- Friendly

- Intelligent

- Sane

- Sincere

- Nerves of steel

- Adventurous

- Intrepid

Ironically, psychopaths possess many of these traits which allow them to be a perfect mimic of a normally functioning person.

Hervey Cleckley, M.D., published a book in 1941, The Mask of Sanity, in which psychopathy was forever immortalized. Dr. Cleckley described the psychopathic person as outwardly disguising their fundamental lack of internal personality structure. Their innate shallowness results in repeatedly purposeful destructive behaviors that is most often self-destructive. In his conceptualization, the psychopathic person does not have the ability to experience genuine emotions, despite the seemingly sincere, intelligent, even charming external presentation.

One of the most notoriously documented psychopaths was Ted Bundy. In case you hadn’t heard, he was an American serial killer, rapist, kidnapper, and necrophile who assaulted and murdered numerous young women and girls during the 1970s.

More alarming than these crimes is the fact that Bundy was a seemingly affable man. He was successful, accomplished, and good looking. Many people were attracted to him and he reportedly possessed many of the popular traits listed above. In addition, however, he held many of the following attributes that define psychopathy.

- Lacking empathy

- Cold-hearted

- Egocentric

- Manipulative

- Impulsive

- Untruthful

- Unresponsive in interpersonal relations

- Sex life trivial, impersonal

- Hedonistic

Most psychopaths are not criminals, however, and can therefore go widely undetected and even advance to power positions. Jon Ronson authored a provocative book called The Psychopath Test, in which he argued that corporate leaders can, in fact, be psychopaths.

A crucial issue regarding the concept of psychopathy is whether it identifies a distinct condition that can be separated from other conditions and 'normal' personality types, or whether it is simply a combination of various personality dimensions found throughout the population in varying combinations.

The bottom line is that psychopaths can be dangerous. Their most serious damage to others is often through their callous disregard that eventually creeps into their day-to-day relationships. Whereas some psychopaths are criminals, most inflict harm by causing concern from others that is met by frustrating and futile efforts to help.

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About the Author

Helen M. Farrell, M.D.

Helen M. Farrell, M.D., is a psychiatrist with Harvard Medical School. She researches forensic psychiatry and violence.

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