Disconnect

Sometimes there are more questions than answers. This is especially odd since so many questions have been asked and answered about psychopathy. 

The truth of the matter is that there are many experts but no consensus on which one has the right answers. Such is the case with psychopathy.

Although the word Psychopath has existed for centuries. First known usage was in 1985. The word breaks down into the Greek word psyche, meaning mentality or soul and path meaning sickness or suffering. Hervey Cleckley (1903-1984) wrote a book in 1941 called The Mask of Sanity in which he gave a much more specific definition of the word. He became interested in psychopaths after having discovered an interesting anomaly in patients of his mental hospital. There were people who seemed really normal and rational but would surprise him with behavior far outside the norm, whatever that was to Cleckley. He developed a checklist of personality traits that, together, make up the personality of a psychopath. These traits are 16 in number and consist of:

Cleckley’s Checklist

1. Superficial charm and good “intelligence.”
2. Absence of delusions and other signs of irrational “thinking.”
3. Absence of “nervousness” or psychoneurotic manifestations.
4. Unreliability.
5. Untruthfulness and insincerity.
6. Lack of remorse or shame.
7. Inadequately motivated antisocial behavior.
8. Poor judgement and failure to learn by experience.
9. Pathologic egocentricity and incapacity for love.
10. General poverty in major affective reactions.
11. Specific loss of insight.
12. Unresponsiveness in general interpersonal relations.
13. Fantastic and uninviting behavior, with drink and sometimes without.
14. Suicide rarely carried out.
15. Sex life impersonal, trivial, and poorly integrated.
16. Failure to follow any life plan.

Robert D. Hare (1934- ), considered the godfather of psychopathy built his own study of psychopathy upon the work of Cleckley. The title of his most widely read book pointed to a core feature of psychopathy: Without Conscience (1993). He also created a checklist of 20 features. This is the checklist currently used.

The PCL-R

• Glib/superficial charm
• Grandiose sense of self worth
• Need for stimulation/proneness to boredom
• Pathelogical lying
• Conning/manipulative
• Lack of remorse or guilt
• Shallow effect
• Callous/lack of empathy
• Parasitic lifestyle
• Poor behavioral controls
• Promiscuous sexual behavior
• Early behavioral problems
• Lack of realistic long term goals
• Impulsivity
• Irresponsibility
• Failure to accept responsibility for own actions
• Short term marital relationships
• Juvenile delinquency
• Revocation of conditional release
• Criminal versatility

One can see a lot of the same traits in each checklist. Throughout recent history, the word psychopathy was replaced by sociopathy around 1929 at a time when environment was thought to have a greater impact on personality than biology. It has since jumped back and forth as thinking has done the same. But most people who use these terms say psychopaths are born that way while sociopaths become that was as a result of trauma or abuse. 

Psychopathy has long been a psychiatric or psychological concept. However, neurologists have discovered that many people diagnosed as psychopaths have distinctive brains that can be seen on MRI or Cat Scans. This difference has given credibility to the notion that psychopathy is a neurological (rather than just psychological) condition probably already present at birth. The distinction between psychopathy and sociopathy is bolstered by that finding.

Both psychopathy and sociopathy have been supplanted in the “bible” of psychiatry, the Diagnostic and Statistical Manual(DSM) created by the American Psychiatric Association (APA). Where these terms would be expected to appear, the term antisocial personality disorder is used. That has caused a fair amount of semantical confusion since ASPD is not considered identical to psychopathy. Many prisoners are diagnosed with ASPD but a smaller number of these are considered psychopaths. Robert Hare spent most of his time studying psychopathy among prisoners. Current standards consider Hare’s checklist appropriate for use on prisoners whose number on the list is considered predictive of recidivism so it is used by parole boards as criteria for when to grant a prisoner parole.

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Tina Taylor

Outside the rarified atmosphere of professionals, there has been a great deal of intelligent lay discussion of psychopathy (in it’s many terms). Tina Taylor publishes a newsletter called Psychopathic Times: Narcissist Nation. Ms. Taylor is of the opinion that, not only can psychopathy be diagnosed by an MRI brain scan, but such scans should be mandatory for all politicians who seek a position in running the country. But some experts deny that the MRI can be used as a diagnostic tool. Neurologist James Fallon is probably the most famous professional to advocate the diagnostic potential of the MRI. His book, The Psychopath Inside tells the story of how he discovered his own inner psychopath after seeing a scan of his own brain. 

One would think psychopathy can be diagnosed by a brain scan. But some neurologists say it can’t be. Chris Chambers, a professor of cognitive neuroscience at the school of psychology, Cardiff University, wrote an article, Could a brain scan diagnose you as a psychopath? The fallacy involved is called the fallacy of reverse inference. In my Logic class, we called it the fallacy of distribution. Just because all crows are black, it doesn’t follow that all black birds are crows. The neurological features of the brain are a lot more complex than James Fallon and Tina Taylor would have it.