Psychopathy is a label originally applied to us by others. Originally, we were just ourselves. Only later, we found out that who and what we were had a name which we came to accept. There are few words that evoke so many different and varied opinions.
Psychopathy is defined as a personality disorder of people who have certain traits. Robert Hare’s PCL-R is a checklist of traits that are characteristic of psychopathy. Robert Hare is a psychologist and only trained practitioners are supposed to administer the test. According to Dr. Hare, the only people qualified to administer this test are “clinicians.”
- Possess an advanced degree in the social, medical, or behavioral sciences, such as a Ph.D., D.Ed. or M.D.
- Be registered with the local state or provincial registration body that regulates the assessment and diagnosis of mental disorder (e.g., psychological or psychiatric association);
- Have experience with forensic populations (as demonstrated by registration as a diploma in forensic psychology or psychiatry, completion of a practicum or internship in a clinical-forensic setting,or at least two years of relevant work-related experience)
- Limit their use of the PCL-R to those populations in which it has been fully validated. The manual, published in 1991, stated that this meant only adult male forensic populations (e.g.,institutional or community correctional facilities, forensic psychiatric hospitals, and pre trial evaluation or detention facilities.) However, there now is enough empirical evidence to support its use with female and adolescent offenders, as well as with sex offenders.
- Insure that they have adequate training and experience in the use of the PCL-R. We further recommend that, wherever possible, the PCL-R scores of two independent raters should be averaged so as to increase the reliability of the assessment.
Quite a list of requirements to interpret a list of 20 qualities. Training can be quite pricey. The Hare PCL-R Training Program can run to $499 or $600. Quite an elitist program. To make matters worse, “psychopathy” does not even appear in the DSM so most psychologists won’t even use the checklist. Instead of listing “psychopathy,” the DSM has “ASPD” OR “Anti-Social Personality Disorder.” The PCL-R is never used to diagnose ASPD. Curiosity.com has the full list. The list of qualities the PCL-R accesses are:
These are the 20 criteria:
– Do you exhibit glib and superficial charm?
– Do you have a grandiose (exaggeratedly high) estimation of self?
– Do you have a constant need for stimulation?
– Are you a pathological liar?
– Are you cunning and manipulative?
– Do you have lack of remorse or guilt?
– Do you have shallow affect (superficial emotional responsiveness)?
– Are you callous, and do you lack empathy?
– Do you have a parasitic lifestyle?
– Do you have poor behavioral controls?
– Are you sexually promiscuous?
– Did you display early behavior problems?
– Do you lack realistic long-term goals?
– Are you overly impulsive?
– Are you irresponsible?
– Do you fail to accept responsibility for own actions?
– Have you had many short-term marital relationships?
– Do you have a history of juvenile delinquency?
– Have you experienced a revocation of conditional release?
– Do you display criminal versatility?
Does it really require the exalted knowledge listed above to apply these descriptions to someone and draw an intelligent inference? Not being one of the anointed, I don’t know. And why does one have to be a psychologist to “diagnose” someone with a condition that isn’t even listed in the DSM (although DSM-V admits “this pattern has also been referred to as psychopathy, sociopathy, or dyssocial personality disorder).”
More confusion is sown by the use of the words “psychopathy” and “sociopathy.” There is no consensus of the meaning of these terms and the difference between them. But most people agree that psychopathy is a neurological condition while sociopathy is psychological and created by the environment. I guess only a brain scan can tell which is which but some say that even sociopaths have distinctive brain scans.
I think psychology and psychiatry were invented as a way stigmatized behaviors could be considered sickness and less stigmatized. The fields are what is called soft science as opposed to physics or chemistry or even biology. It has always lacked the precision of the hard sciences. Although more and more of “mental illness” is being found to have a physical correspondence, most behavior grows out of the will. Tourette syndrome can cause “behavior” for which the person has no responsibility but that’s the exception. Behavior disorders are patterns of behavior the majority of mainstream society just flat-out doesn’t like. You can give it a fancy psychiatric term but people judge it anyway. Psychopathy is especially stigmatized. The most outlandish explanations have been hatched. Psychopaths have been said to be shape-shifting reptiles, for example. People question our very humanity. M. Scott Peck has tried to combine moral opprobrium with science in his book People of the Lie, subtitled The Hope of Healing Human Evil. “Evil” isn’t normally referred to as something that needs to be “healed.” Can someone be “sick” and “evil” at the same time? What is sickness? What is evil? Both are phenomena that bother others, that society would like to banish. But sickness isn’t considered the fault of a sick person. Evil is supposedly freely chosen.
On the web, groups of people have come together as self-proclaimed victims of “evil” psychopaths and narcissists. The “evil” is usually at the hands of mothers or lovers. Ironic how people can go from an intimate relationship with someone to suggesting they aren’t even human.
No matter how psychopathy is defined, it is clearly a word meant to denote pathology. Psychopath means something wrong. How are those of us who carry that label supposed to deal with the fact that society sees us as something wrong regardless of which of many opinions out there about how and why we are “wrong?” We have all had to come to terms with the awareness that we were different right from the start. It causes us to know we are alone in a way few people experience. But, as Ayn Rand put it, “every aloneness is a pedestal.”