Most of us have our lists of people whom we regard as profoundly evil. And a number of us also think that the people on our lists are mentally ill, deranged, insane, or crazy. But is being evil really a mark of mental illness? Can moral character determine mental health?
Without a clear understanding of what it means to be evil, it is difficult to answer this question. So what, in the first place, does it mean to be evil?
People are not evil because they have done bad things or else we'd all be evil. As Aristotle maintained, being evil portends a persistent habit of doing bad things. Moreover, evil people know that what they are doing is bad but choose to do so anyway. They therefore act with malicious intent. Moreover, evil people typically care little or not at all that what they are doing is or may be harmful to others; and some evil people even derive sadistic pleasure from it. Moreover, some evil people are very cunning and can disguise their evil intentions and lack of regard for others. These individuals may be con artists or even charming rapists or murderers. Of course, there are degrees of evil and some evil people are not as evil as others. For example, it is arguable that a person willing to kill you and be amused by it is more evil than a person who is only willing to steal your money.
Indeed, there are some evil people, so-called "sociopaths," who have Antisocial Personality Disorder and are therefore mentally ill according to current psychiatric standards. For example, the Ted Bundies and Jeffrey Dahmers of the world can commit brutal murders with little or no remorse. But these cases are rare and the vast majority of sociopaths are not mass murderers
According to the DSM 4-TR,"The essential feature of Antisocial Personality Disorder is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood." (p. 701)
So here is a mental disorder that is, in fact, defined in terms of moral deviance. According to the DSM 4-TR, anyone fitting this diagnostic classification must satisfy the following diagnostic criteria:
A. There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following:
1. failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
2. Deceitfulness, as indicated by repeated lying, uses of aliases, or connong others for personal profit or pleasure
3. impulsivity or failure to plan ahead
4. irritability and aggressiveness, as indicated by repeated physical fights or assaults
5. reckless disregard for safety of self or others
6. consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
7. lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another
B. The individual is at least 18 years old.
C. There is evidence of conduct disorder...with onset before age 15 years.
D. The occurrence of antisocial behavior is not exclusively during the course of Schizophrenia or Manic Episode (p. 706).
So, do all or most people 18 years or over whom you would consider evil also satisfy the above criteria? If so, then all or most evil people you know are sociopaths; and since being a sociopath means being mentally ill, this also means that all or most of these people are mentally ill. For instance, consider whether all or most evil people on your evil persons list tend to lie, disregard the safety or welfare of others, and rationalize or show little or no remorse for the pain they inflict on others. According to DSM standards, as long as C and D above are also satisfied, this would make such people mentally ill.
But some "anti-psychiatrists," notably Thomas Szasz, would argue that mental illness is itself a myth; and that therefore terms such as "sociopath" and "Antisocial Personality Disorder" are themselves just moral judgments disguised as empirically verifiable psychiatric disorders. "We call people mentally ill," argues Sasz, "when their personal conduct violates certain ethical, political, and social norms." Is this view correct? Is calling someone a sociopath, or saying that the person has Antisocial Personality Disorder, merely a concealed way of calling the person evil?
Further, many evil people do not suffer from any form of psychosis or perceptual or reasoning impairment. In fact, as I have already suggested, many evil people can be quite clever and thus reason well about means to attaining their ends. But though their means-end reasoning may be quite rational, one might question the rationality or "sanity" of their particular means or ends. Thus, an evil person may devise a very clever plan to collect the inheritance of a relative through murder or deception, and thereby attain his or her end unjustly. The use of such morally bankrupt means to attain the end of getting money is clearly evil; but is it also crazy?
In the end, it is only by supposing that, people in a persistent habit of callously committing serious moral transgressions are mentally ill, that we can defend the claim that evil people are or tend to be mentally ill. But, as just stated, such individuals can be otherwise rational and realistic.
Ancient natural law theorists such as Aristotle, medieval theorists such as Saint Thomas Aquinas, and contemporary theorists such as Eric Fromm would not have a problem with making the stated assumption. For these theorists, there are certain basic human tendencies that are "normal" and those who deviate from them are, in effect, mentally ill. Thus all of the aforementioned theorists hold that human beings are by nature social creatures. So, people who kill, rape, and steal from others are transgressing this moral order of nature.
In contrast to these natural law theorists are existentialists such as Jean-Paul Sartre who believe that all moral standards are human artifacts, and that there is therefore no objective "human nature" or set of nature laws upon which to ground mental health. According to this view, for human beings, "existence precedes essence"; that is, we exist first and only then define who (or what) we are. So, the evil person has carved out his own "nature" through his life choices and is fully responsible for it.
If you accept such a moral relativism, then you will probably be disinclined toward thinking that, people who violate cultural or ethical standards are mentally ill. You will instead believe that such people have freely made life choices to become the sort of people that they have become, and are therefore fully responsible for who they are. On the other hand, if the natural law view of human nature appeals to you, then you will have an easier time accepting that evil people are mentally ill. But, if, like Sasz, you are skeptical in the first place about ascribing psychiatric labels to morally unacceptable moral habits, then you will see things quite differently.
So, there are at least three contrasting perspectives you could take on the question of whether evil people are mentally ill. Where do you stand?