Is Psychopathy Really a Disorder?


“Psychopaths are not disordered. They don’t suffer from a deficit, but they’re simply different”. — Dr. Robert Hare in a speech to his students, The Psychopath Next Door


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In this blog, I have been discussing psychopathy as part of the Cluster B personality disorders. This is not inline with the DSM which has replaced it with the Anti-Social Personality Disorder. Since ASPD is not the same thing as psychopathy, (“Most psychopaths (with the exception of those who somehow manage to plow their way through life without coming into formal or prolonged contact with the criminal justice system) meet the criteria for ASPD, but most individuals with ASPD are not psychopaths.”– Dr. Robert Hare, Psychopathy and Antisocial Personality Disorder: A Case of Diagnostic Confusion), it brings up the question is psychopathy a disorder at all? It’s not in the DSM although the “manual” is more a tomb, thicker than many encyclopedias.

Hare is considered the leading authority on psychopathy. His checklist (HPC-R) is considered the gold standard for diagnosing psychopathy. One can see that the language used in discussing psychopathy is the language of a doctor talking about a patient.

The forerunner of Robert Hare in the field of psychopathy is Dr. Hervey Cleckley, upon whose book, The Mask of Sanity In Cleckley’s days, there was a lot of confusion about psychopathy.”This cumbersome and altogether vague diagnostic category officially includes a wide variety of maladjusted people who cannot by the criteria of psychiatry be classed with the psychotic, the psychoneurotic, or the mentally defective. It is by no means uncommon in looking over the reports of a psychiatric examination to find conclusions listed as follows:

  1. No nervous or mental disease.
  2. Psychopathic personality” — Cleckley, Mask of Sanity

Cleckley’s experience with people he considered psychopathic was often when someone would get himself transferred from prison to his psychiatric facility, Cleckley was cleckleystruck by how normal and rational the person seemed. Then, according to many case studies he would use his parole from the hospital to get roaring drunk. This happened often enough for me to conclude that most of the psychopaths Cleckley encountered were alcoholics and that they played the good doctor for a patsy. Despite the number of times this happened, Cleckley gave them another chance. They were manipulative, involving, not only Cleckley, but their relatives.

hareHare, following up on Cleckley’s work, gave a much clearer and more recognizable (to the modern mind) picture of psychopathy. His best known work is Without Conscience. Hare’s studies were mostly conducted on prisoners. Later Hare was to say he wished he had made his study on the trading floor on Wall Street. He followed up his book with Snakes in Suits which he coauthored Paul Babiak about psychopaths in the corporate world.

To further complicate things, scientists found that the psychopaths’ brains were significantly different from most people’s brains. Brain waves, measured by the EEG were so different that Hare’s editor refused to accept them as legitimate brain waves. “Those EEGs could not have come from real people,” he said. Do all psychopaths have these brain anomalies? If not, should we call the ones who don’t “sociopaths” as distinct from those psychopaths who do? There is great variety in how people use the word “sociopath” and “psychopath.” Some use them interchangeably, some say psychopaths are born that way as evidence their brains and sociopaths become “that way.”

anomSo psychopathy remains a mysterious source of confusion for those who would define it. Although it is not in the DSM, most people still continue to discuss it as an illness. People who are assessed as psychopaths are “diagnosed.” The people who give out those diagnoses are called “doctors.” However, Dr. Robert Hare has said, “Psychopaths are not disordered. They don’t suffer from a deficit, but they’re simply different”. So the APA wasn’t wrong, after all, in removing psychopathy from the DSM. It isn’t a disorder at all, although ASPD, anti-social personality disorder, which many psychopaths can be diagnosed as “suffering” from, is. The corporate psychopaths are certainly considered winners. They may be hated but their power is respected. Those who fall under the penal system, have less ability to choose how they are measured. There are few voluntary psychiatric patients. Psychopaths don’t believe we need treatment. Most of us consider the condition an advantage. It seems that, unlike “other” mental disorders, psychopathy is only a problem for others around us. But most of us don’t give a damn.

Perhaps none of the “personality disorders” are anything but what society and psychiatrists want to make diseases rather than something calling for a moral judgement. As Hare says, “This book confronts psychopathy head-on and presents the disturbing topic for what it is—a dark mystery with staggering implications for society; a mystery that finally is beginning to reveal itself after centuries of speculation and decades of empirical psychological research.”
— Hare, Without Conscience

“It’s a poem about moths. But it’s also a poem about psychopaths.
I get it copied. And stick it in a frame.
And now it glowers redoubtably above my desk:an entomological keepsake of the horizons of existence.
And the brutal, star-crossed wisdom of those who seek them out.
i was talking to a moth
the other evening
he was trying to break into
an electric bulb
and fry himself on the wires
candle
why do you fellows
pull this stunt i asked him
because it is the conventional
thing for moths or why
if that had been an uncovered
candle instead of an electric
light bulb you would
now be a small unsightly cinder
have you no sense
plenty of it he answered
but at times we get tired
of using it
we get bored with routine
and crave beauty
and excitement
fire is beautiful
and we know that if we get
too close it will kill us
but what does that matter
it is better to be happy
for a moment
flameand be burned up with beauty
than to live a long time
and be bored all the while
so we wad all our life up
into one little roll
and then we shoot the roll
that is what life is for
it is better to be part of beauty
our attitude toward life
is come easy go easy
we are like human beings
used to be before they became
too civilized to enjoy themselves
and before i could argue him
out of his philosophy
he went and immolated himself
on a patent cigar lighter
i do not agree with him
myself i would rather have
half the happiness and twice
the longevity
but at the same time i wish
there was something i wanted
as badly as he wanted to fry himself”
quoted by Kevin Dutton, The Wisdom of Psychopaths
The Lesson Of The Moth by Don Marquis

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