What We Get Wrong About Psychopaths

We have gone to great lengths to both mystify and monsterize psychopaths.

Posted Feb 07, 2019

Jocie Juritz, used with permission
Snakes in Suits
Source: Jocie Juritz, used with permission

We have an unhealthy obsession with psychopaths.

We tune into true crime shows, podcasts, and movies, and say that we want to understand them, to get into their heads and figure out their malicious ways. But sometimes it’s not really the psychopaths we want to understand. Instead, we want to establish a stark contrast between how they think and how we think. We want assurance that we are better than these modern monsters.

Journalists and fiction writers and even psychologists and criminologists have gone to great lengths to both mystify and make monsters out of psychopaths.

When famous experts label psychopaths in corporate settings as “snakes in suits,” and authors describe interviews with psychopaths as “a journey into the evil mind,” we can quickly venture into a cycle of dehumanizing. When the word evil enters a conversation, we must question not just the mind and motives of the individual being discussed, but that of the person using the term.

Despite using the label psychopath regularly, most of us don’t really know what psychopathy is. Even clinical psychologists can harbor incorrect assumptions. Are psychopaths actually more prone to violence? Are they a homogeneous group? Where does the term even come from?

Psychopathy is perhaps the single most misunderstood personality disorder.

What is a psychopath?

In my new book Evil: The Science Behind Humanity’s Dark Side, I tear into common notions of evil. As I deconstruct the term, I discuss the various ways we must better understand the personality constructs that lead to antisocial behavior. In the process, I help the reader explore their own dark tendencies, and I foster a sense of empathy that encourages us to treat those who carry damning labels as fully formed human beings.

Part of this discussion involves exploring the fascinating ways psychopathy is linked with evil. In the following section, I explain the concept briefly:

     In 1833, Dr James Prichard formulated an early version of what we now call psychopathy. He called it ‘moral insanity’.[ii] People diagnosed with moral insanity were thought to make bad moral judgments, but had no defects in their intelligence or mental health. Psychopaths, too, are often clever and sane, and are more likely to do things that are widely considered to be immoral.

     Today, the most commonly used definition of psychopathy comes in the form of the Psychopathy Checklist Revised (PCL-R).[iii] The first psychopathy checklist was created in the 1970s by Canadian psychologist Robert Hare, as a more structured way for psychologists and researchers to diagnose someone as a psychopath. Based on the checklist, some of the defining features of psychopathy are: superficial charm, lying, lack of remorse, antisocial behavior, egocentricity and — most importantly — a lack of empathy.

     Most would argue that the defining feature of psychopathy is the lack of empathy. A lack of empathy is strongly linked with crime. Such a diagnosis means that when the person commits crimes or breaks rules, they aren’t weighed down by things like remorse or sadness. Empathy really gets in the way of hurting people. Psychopaths can be particularly ruthless, and I have more than once heard them referred to by academics matter-of-factly as monsters.

     There seems to be the consensus that there are offenders and then there are psychopathic offenders. They seem to live in a separate, scary, category.

It’s like psychologists are giving us, and themselves, a carte blanche to discriminate and distance ourselves from this group.

It’s time we examine our own misconceptions.

Six myths about psychopaths

Researchers like Jennifer Skeem and colleagues argue that psychopathy is widely misunderstood. In 2011, they published a fantastic, myth-debunking monograph [iv] about psychopathy, including these major misconceptions.

Jocie Juritz, with permission
The mythical psychopathic snake
Source: Jocie Juritz, with permission

Myth 1: Psychopathy is synonymous with violence.

Most psychopaths are not offenders, and even offending psychopaths are not necessarily violent. The fact that many psychopaths have traits that make them more likely to be violent does not mean that they will be violent.

According to Skeem:

     “Psychopathy cannot be equated with extreme violence or serial killing. In fact, psychopaths do not appear different in kind from other people, or inalterably dangerous.”

They argue that it's particular traits within the larger construct of psychopathy that are related to violence, not the whole personality disorder.

Myth 2: Psychopathy is synonymous with psychosis.

In the monograph, Skeem and colleagues also express frustration with the common mix-up of the words psychopath and psychosis. As they explain:

     "Perhaps owing in part to the similarity between the words psychopath and psychotic, a common assumption in everyday life is that psychopaths are irrational, out of touch with reality, or both . . . In contrast with psychotic patients, psychopathic individuals are generally rational, free of delusions, and well oriented to their surroundings (Cleckley, 1941, 1988), and those who commit crimes are almost always aware that they have done wrong in the eyes of the law."

Psychopaths may know what they are doing, and that what they are doing is technically bad, but they may not feel the same about it as non-psychopaths, because of their diminished capacity for empathy.

I can add to this that psychopathy and psychopathology are also not the same thing. Psychopathology refers to the general study of mental illness and helps psychologists understand the course of particular mental health problems.

Myth 3: Psychopathy is synonymous with antisocial personality disorder (ASPD).

Skeem and colleagues explain:

     "ASPD is an official diagnosis marked by a chronic history of antisocial, criminal, and sometimes violent behavior dating back to childhood or early adolescence."

First of all, ASPD is an official diagnosis that can be made with the Diagnostic and Statistical Manual of Mental Disorders (DSM), which is the major handbook that psychologists use to determine whether someone can be diagnosed with a mental illness. Psychopathy is still not in this handbook, although it is widely accepted as a personality disorder. Why is psychopathy not in the DSM? Well, that's a whole other story.

Second, the diagnosis of ASPD relies almost entirely on antisocial behavior, while the diagnosis for psychopathy relies more on personality traits. Within criminal psychology, most of us dislike ASPD, because it applies by default to most offenders, while psychopathy helps to differentiate between offenders based on meaningful personality differences.

Myth 4: Psychopathic individuals are born, not made.

Like with everything in psychology, this disorder comes from a combination of nature and nurture.

This may also help explain why most children who are predisposed to psychopathy never become psychopaths. If a child high on what are referred to as callous-unemotional traits (i.e., has the foundations of psychopathy) grows up in a household that encourages cooperation and teaches pro-social values, this reduces the odds of them developing into a psychopath. Conversely, if a child with these same traits grows up in a toxic environment, their predispositions make it more likely to flesh out into a mature diagnosis of psychopathy.

Myth 5: Psychopathic traits do not change.

Being labeled a psychopath can forever change your life.  A diagnosis of psychopathy changes how an individual is approached, and how suitable they are considered to be for treatment. Unfortunately, the approach to treatment for psychopaths is often “don’t bother,” because the assumption that psychopaths can’t be treated is still widespread.

Skeem and colleagues write that:

     "recent empirical work has emerged to suggest that personality traits in general, and psychopathic traits more specifically, undergo change [over the lifespan] . . . [and] youth and adults with high scores on measures of psychopathy can show improved behavior after intensive treatment"

Skeem herself is responsible for spearheading some of this game-changing research on treating psychopaths.

Jocie Juritz, with permission
We need to show compassion, even for people we don't like.
Source: Jocie Juritz, with permission

Myth 6: All psychopaths are the same.

As Skeem has argued:

     “Psychopathy has long been assumed to be a single personality disorder. However, there is increasing evidence that it is a confluence of several different personality traits.”

These personality traits include disinhibition, boldness, and meanness — none of which are exclusive to psychopaths, but together can result in a potent mix.

Perhaps the most troubling finding in the monograph is that some people are diagnosed as psychopaths who aren’t psychopaths at all. Skeem and colleagues report that a significant minority of adult and young offenders who were labeled psychopathic could be more accurately described as emotionally disturbed and emotionally detached. Instead of psychopathy, anxiety and dysphoria (a general dissatisfaction with life) may be more fitting diagnoses.

Finally, let us try not to fall into the destructive rhetoric that psychopaths are somehow sub-human. Psychopaths are no less deserving of our understanding or help than anyone else. Nor should someone be described as a psychopath just because you disapprove of their actions or don’t like them. Not all jerks are psychopaths, and not all psychopaths are jerks.

References

[i] Balsis, S., Busch, A. J., Wilfong, K. M., Newman, J. W., & Edens, J. F. ‘A statistical consideration regarding the threshold of the psychopathy checklist – revised’. Journal of Personality Assessment, 99 (5) (2017), pp. 1–9.

[ii] Augstein, H. F. ‘J. C. Prichard’s concept of moral insanity – a medical theory of the corruption of human nature’. Medical History, 40 (3) (1996), p. 311.

[iii] Hare, R. D. The Hare Psychopathy Checklist – Revised, 2nd ed. Toronto, ON: Multi-Health Systems, Inc., 2003.

[iv] Skeem, J. L., Polaschek, D. L., Patrick, C. J., & Lilienfeld, S. O. (2011). Psychopathic personality: Bridging the gap between scientific evidence and public policy. Psychological Science in the Public Interest, 12(3), 95-162.