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A Primer on Psychopathy -- By David S. Kosson and Robert D. Hare
What Psychopath Means -- Scott O. Lilienfeld and Hal Arkowitz
Reproduced with permission. © 2007 Scientific American Inc. All Rights Reserved.
This Charming Psychopath -- By Robert D. Hare
Reproduced with permission. © 2007 Psychology Today All Rights Reserved.
The concept of psychopathy or psychopathic personality has been around for a long time under a variety of different names and with several different but overlapping definitions. The first conceptualization usually linked to the modern concept of the disorder was Philippe Pinel's description of manie sans delire, which is loosely translated as "insane but not delirious." (Delirium refers to a state of severe mental agitation and confusion). The modern view of the psychopathic individual as suffering from a specific personality disorder originated in the clinical descriptions of several psychiatrists during the first half of the twentieth century, particularly those provided by Hervey Cleckley in his book, The Mask of Sanity, (1941/1976). Cleckley postulated that psychopathy involves difficulty in understanding the meaning and significance of human behavior and leads to a pervasive deficit in the experience of emotion. The title of the book conveys Cleckley's view that psychopathic individuals do not appear insane in the usual sense of the word.
Contemporary
Measures of Psychopathy
The contemporary clinical assessment of psychopathy is based primarily on the Psychopathy Checklist-Revised (PCL-R), developed by Robert Hare (Hare, 2003). The PCL-R is widely regarded as the "gold standard" for psychopathy assessment in clinical and forensic populations (Acheson, 2005, pp. 429–431). It consists of 20 items selected on the basis of an integration of several sources of information, including the clinical writings of Cleckley and other early clinicians, and the research and applied literature.
The specific traits are not easy to diagnose. In fact, it requires substantial training to reliably assess psychopathy using the PCL-R. One of the reasons that the PCL-R is difficult to use is that it requires raters to integrate information across multiple sources of information (statements by the person himself or herself, official records or other people who know the person and provide collateral information, and the observations and impressions of an interviewer) and across multiple domains of behavior (behavior during childhood and adolescence, behavior in school, on jobs, in one's family of origin, behavior towards friends and relationship partners, antisocial behavior, and recreational interests and hobbies). However, when trained raters have access to both interviews and collateral sources, they are routinely able to achieve very high reliability in research settings.
Since the development of the PCL-R, there has been a dramatic increase in research on psychopathy. A variety of other instruments have been developed to assess psychopathic features. The Psychopathy Checklist: Youth Version (PCL: YV) was developed for assessing psychopathic traits in adolescents (Forth, Kosson, & Hare, 2003). The Psychopathy Checklist: Screening Version (PCL: SV) permits assessment of psychopathic traits in psychiatric patients and in the general population (Hart, Cox, & Hare, 1995). As with the PCL-R, these measures require extensive training and use of collateral sources of information to provide clinical assessments of psychopathy. In addition, because we know very little about the long-term stability of psychopathic features in youth, the PCL: YV manual emphasizes that nobody should ever label a child or adolescent a "psychopath." The term has many negative connotations, and there is evidence that labels like "psychopath" or "mentally ill" can hurt the way that youth are treated by parents, teachers, and peers. However, there is substantial evidence that both the PCL: YV and the PCL: SV are reliable and valid ways of identifying adolescents and adults with psychopathic features.
There are several other measures that sometimes are used in research contexts to screen individuals for psychopathic traits. One such measure is the Antisocial Processes Screening Device (APSD) used in research on the early precursors and development of psychopathy (Frick & Hare, 2003). There are also several self-report measures available for assessing psychopathic traits. However, because scores on these measures are not highly correlated with the PCL-R or its derivatives, they may be measuring, to some extent, different aspects of personality problems. Additional research is necessary to establish the degree to which the different measures converge on the psychopathy construct.
Research on Psychopathy
Individuals with psychopathic traits have been demonstrated to exhibit specific kinds of emotional and cognitive deficits and specific physiological anomalies in several different laboratory situations. These findings provide important clues to mechanisms underlying psychopathic personality, and may help us to understand the causes of psychopathy and to treat individuals with psychopathic traits. In addition, research has established that individuals with many psychopathic traits commit more crimes and more violent crimes than individuals without such traits, and are more likely to violate institution rules, as well as the terms of probation and parole. Psychopathy is also a potent predictor of future violent crime. These findings show that identifying individuals with psychopathic traits can be very useful for criminal justice professionals in predicting which people are likely to violate rules and get into trouble. However, psychopathy is not a perfect predictor of violence or crime, and there is increasing evidence that some people with psychopathic traits do not break the law or that they learn to function in an adaptive way. The "Links" page provides links to websites that list research articles and books on psychopathy. Additional research findings on psychopathy may be posted on this website over time.
Use of this Resource
Because improper use of the PCL-R could lead people to misdiagnose psychopathy when it is not present, we do not present the PCL-R items on this website, and we urge you to avoid the temptation to diagnose psychopathy in people you know. Nevertheless, because individuals with many psychopathic traits often behave in ways that are confusing and hurtful, and, in some cases, dangerous, we recognize that people may want to have an informal basis for judging whether they may be in relationships with individuals with psychopathic traits. Moreover, although there are few large sample epidemiological studies of the prevalence of psychopathy in community settings, the available data suggest that the disorder may be more common than was previously thought and may afflict as many as 1% of adult males as well as an unknown (but probably smaller) percentage of adult females.
The features of psychopathy can be grouped together into dimensions that can be useful in understanding and predicting behavior. We provide here brief definitions of these dimensions. However, we emphasize that psychopathy is not simply one of these dimensions. A person can be said to have psychopathic traits to the extent that they exhibit the qualities embodied in all or most of these dimensions on a regular basis, across situations. (General descriptions of items similar to those in the PCL: SV are provided in Hare's 1999 book, Without Conscience).
Early analyses by Harpur, Hare and Hakstian (1989) identified two related clusters of items, or factors, underlying PCL total scores, the first (Factor 1) reflecting affective and interpersonal traits of psychopathy, and the second (Factor 2) reflecting the lifestyle and antisocial features of the disorder. More recent factor analytic studies have proposed a four-factor model of psychopathy as measured by the PCL-R (Hare, 2003, Neumann, Hare, & Newman, 2007), the PCL: SV (Vitacco, Neumann, & Jackson, 2005), and the PCL: YV (Neumann, Kosson, Forth, & Hare, 2005). In this model, each of the original factors is divided into two dimensions: Interpersonal, Affective, Lifestyle, and Antisocial). A three-factor model in which the antisocial dimension is omitted also has been proposed (Cooke, Michie, Hart, & Clark, 2004).
To aid visitors to this website, we provide here a basic summary of the four factors, with the caveat that not all researchers agree about the centrality of the antisocial factor.
The Interpersonal Dimension: Individuals with psychopathic traits are commonly characterized by a smooth interpersonal style and an ability to effectively manipulate others. Although they may be quite straightforward and direct at times, they are prone to use deception under a variety of circumstances and may be quite adept at fooling others, getting out of trouble, and persuading others to do what they want. Such individuals also tend to be interpersonally dominant and even arrogant, at times exuding tremendous self-confidence and an exaggerated sense of their abilities or influence. Even so, just as there are many different ways to influence an impression, different individuals with psychopathic traits may differ widely in their usual interpersonal style, and the same individuals may differ substantially in their presentation to different people in different situations.
The Affective Dimension: Although often not obvious at first, the behavior of individuals with psychopathic traits frequently suggests that they are less impacted by emotional experiences than are others. Part of what makes this lack of emotional reactivity difficult to detect is that everyone displays emotion in different ways. Some people show emotion on their faces and in their voices; some respond with physical signs of arousal, and some do not. Moreover, although some individuals with psychopathic features may tell you directly that they do not care about other people, others will indicate that they are very upset upon learning that a friend or relative has experienced stress, failure, injury, or illness. However, there may be few signs that they are slowed down, preoccupied, or distracted by such events. In fact, some individuals with psychopathic traits will argue that interpersonal relationships are very important to them: they demonstrate their lack of attachment only through their actions, deceiving and hurting those who appear closest to them with little appreciation for the impact of their behavior on others. Moreover, when things go wrong, they are often adept at explaining the chain of events in a way that leaves them with no responsibility for negative outcomes.
The Lifestyle Dimension: People with psychopathic traits often neglect their commitments and responsibilities to others. Sometimes, they may decide to change partners or jobs impulsively or even act in ways that seem to undercut their own priorities. In other cases, they consistently verbalize commitment to others, but their behavior suggests otherwise. They may have difficulty resisting exciting opportunities or an irresistible need for stimulation that somehow eclipses prior promises or plans, or they may have difficulty tolerating mundane jobs or sticking with routines. In some cases, individuals with psychopathic traits may demonstrate an unwillingness to support themselves financially. Regardless of the reasons, they tend over time to fail to meet commitments (e.g., paying bills, contributing resources, honoring marital and business contracts) and behave in ways that put others at risk either willfully, recklessly, or through inattention to the needs of others.
The Antisocial Dimension: The antisocial dimension is associated not with criminal behavior per se, but with early, versatile, and persistent antisocial behavior that often is extremely distressing and frustrating for others.. However, individuals with psychopathic features are more likely than others to commit offenses, including violent offenses. Their criminal activities tend to be persistent and generalized, not confined to only one type of offense. In addition, although some of their criminal activities may involve substantial planning, some of their crimes often seem impulsive or even careless. Part of the reason for such crimes is that many psychopathic offenders display poor frustration tolerance and difficulty controlling their anger. They are likely to over-react to provocations and to obstacles that block their immediate goals, and this reactivity represents an important caveat to the above description of a lack of emotional reactivity; their general lack of emotionality should not be construed as suggesting that individuals with psychopathic qualities are necessarily easy-going or immune to frustrations. In addition, several studies suggest that psychopathic offenders are more prone than other offenders to violate the rules of probation, parole, and correctional and treatment facilities. Their persistent rule-violations and criminal activity appear quite useful in identifying psychopaths within offender samples. Although there have been few studies addressing the importance of these features in non-offender samples, the available research is consistent with clinical lore about individuals with psychopathic personalities who do not break the law.
References
Acheson, S.K. (2005). Review of the Hare Psychopathy Checklist-Revised, 2nd edn.). In R.A. Spies & B.S. Plake (eds.) (2005). The Sixteenth Mental Measurements Yearbook (pp. 429–31). Lincoln, NE: Buros Institute of Mental Measurements.
Cooke, D. J., Michie, C., Hart, S. D., & Clark, D. A. (2004). Reconstructing psychopathy: Clarifying the significance of antisocial and socially deviant behavior in the diagnosis of psychopathic personality disorder. Journal of Personality Disorders, 18, 337-357.
Forth,
A. E., Kosson, D. S., & Hare, R. D. (2003). The Hare Psychopathy
Checklist: Youth Version: Technical Manual.
Multi-Health Systems, North Tonawanda, New York.
Hare, R.D. (2003). Manual for the Psychopathy Checklist-Revisited, 2nd Edition. Toronto, Ontario, Canada: Multi-Health Systems.
Hare, R. D. (1999). Without Conscience: The disturbing world of the psychopaths among us. New York: Guildford Press.
Hart, S. D., Cox, D. N., & Hare, R. D. (1995). The Hare Psychopathy Checklist: Screening Version (PCL: SV). Toronto, Canada: Multi-Health Systems, North Tonawanda, New York.
Neumann, C. S., Hare, R. D., & Newman, J. P. (2007). The super-ordinate nature of the psychopathy checklist-revised. Journal of Personality Disorders, 21, 102-107.
Neumann, C. S., Kosson, D. S., Forth, A. E., & Hare, R. D. (2006). Factor structure of the Hare Psychopathy Checklist: Youth Version in incarcerated adolescents. Psychological Assessment, 18, 142-154.
Vitacco,
M. J., Neumann, C. S., & Jackson, R. L. (2005). Testing a Four-Factor Model
of Psychopathy and Its Association With Ethnicity, Gender, Intelligence, and
Violence.
Journal of Consulting and Clinical Psychology, 73, 466-476.
We have all heard these phrases before. "Violent psychopath" (21,700). "Psychopathic serial killer" (14,700). "Psychopathic murderer" (12,500). "Deranged psychopath" (1,050). The number of Google hits following them in parentheses attests to their currency in popular culture. Yet as we will soon discover, each phrase embodies a widespread misconception regarding psychopathic personality, often called psychopathy (pronounced "sigh-COP-athee") or sociopathy. Indeed, few disorders are as misunderstood as is psychopathic personality. In this column, we will do our best to set the record straight and dispel popular myths about this condition.
Charming but Callous
First described systematically by Medical College of Georgia psychiatrist Hervey M. Cleckley in 1941, psychopathy consists of a specific set of personality traits and behaviors. Superficially charming, psychopaths tend to make a good first impression on others and often strike observers as remarkably normal. Yet they are self-centered, dishonest and undependable, and at times they engage in irresponsible behavior for no apparent reason other than the sheer fun of it. Largely devoid of guilt, empathy and love, they have casual and callous interpersonal and romantic relationships. Psychopaths routinely offer excuses for their reckless and often outrageous actions, placing blame on others instead. They rarely learn from their mistakes or benefit from negative feedback, and they have difficulty inhibiting their impulses.
Not surprisingly, psychopaths are overrepresented in prisons; studies indicate that about 25 percent of inmates meet diagnostic criteria for psychopathy. Nevertheless, research also suggests that a sizable number of psychopaths may be walking among us in everyday life. Some investigators have even speculated that "successful psychopaths"those who attain prominent positions in societymay be overrepresented in certain occupations, such as politics, business and entertainment. Yet the scientific evidence for this intriguing conjecture is preliminary.
Most psychopaths are male, although the reasons for this sex difference are unknown. Psychopathy seems to be present in both Western and non-Western cultures, including those that have had minimal exposure to media portrayals of the condition. In a 1976 study anthropologist Jane M. Murphy, then at Harvard University, found that an isolated group of Yupik-speaking Inuits near the Bering Strait had a term (kunlangeta) they used to describe "a man who repeatedly lies and cheats and steals things and takes sexual advantage of many womensomeone who does not pay attention to reprimands and who is always being brought to the elders for punishment." When Murphy asked an Inuit what the group would typically do with a kunlangeta, he replied, "Somebody would have pushed him off the ice when nobody else was looking."
The best-established measure of psychopathy, the Psychopathy Checklist-Revised (PCL-R), developed by University of British Columbia psychologist Robert D. Hare, requires a standardized interview with subjects and an examination of their file records, such as their criminal and educational histories. Analyses of the PCL-R reveal that it comprises at least three overlapping, but separable, constellations of traits: interpersonal deficits (such as grandiosity, arrogance and deceitfulness), affective deficits (lack of guilt and empathy, for instance), and impulsive and criminal behaviors (including sexual promiscuity and stealing).
Three Myths
Despite substantial research over the past several decades, popular misperceptions surrounding psychopathy persist. Here we will consider three of them.
1. All psychopaths are violent. Research by psychologists such as Randall T. Salekin, now at the University of Alabama, indicates that psychopathy is a risk factor for future physical and sexual violence. Moreover, at least some serial killers-for example, Ted Bundy, John Wayne Gacy and Dennis Rader, the infamous "BTK" (Bind, Torture, Kill) murderer-have manifested numerous psychopathic traits, including superficial charm and a profound absence of guilt and empathy.
Nevertheless, most psychopaths are not violent, and most violent people are not psychopaths. In the days following the horrific Virginia Tech shootings of April 16, 2007, many newspaper commentators described the killer, Seung-Hui Cho, as "psychopathic." Yet Cho exhibited few traits of psychopathy: those who knew him described him as markedly shy, withdrawn and peculiar.
Regrettably, the current (fourth, revised) edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders Text Revision (DSM-IV-TR), published in 2000, only reinforces the confusion between psychopathy and violence. It describes a condition termed antisocial personality disorder (ASPD), which is characterized by a longstanding history of criminal and often physically aggressive behavior, referring to it as synonymous with psychopathy. Yet research demonstrates that measures of psychopathy and ASPD overlap only moderately.
2. All psychopaths are psychotic. In contrast to people with psychotic disorders, such as schizophrenia, who often lose contact with reality, psychopaths are almost always rational. They are well aware that their ill-advised or illegal actions are wrong in the eyes of society but shrug off these concerns with startling nonchalance.
Some notorious serial killers referred to by the media as psychopathic, such as Charles Manson and David Berkowitz, have displayed pronounced features of psychosis rather than psychopathy. For example, Manson claimed to be the reincarnation of Jesus Christ, and Berkowitz believed he was receiving commands from his neighbor Sam Carr's dog (hence his adopted nickname "Son of Sam"). In contrast, psychopaths are rarely psychotic.
3. Psychopathy is untreatable. In the popular HBO series The Sopranos, the therapist (Dr. Melfi) terminated psychotherapy with Tony Soprano because her friend and fellow psychologist persuaded her that Tony, whom Dr. Melfi concluded was a classic psychopath, was untreatable. Aside from the fact that Tony exhibited several behaviors that are decidedly nonpsychopathic (such as his loyalty to his family and emotional attachment to a group of ducks that had made his swimming pool their home), Dr. Melfi's pessimism may have been unwarranted. Although psychopaths are often unmotivated to seek treatment, research by psychologist Jennifer Skeem of the University of California, Irvine, and her colleagues suggests that psychopaths may benefit as much as nonpsychopaths from psychological treatment. Even if the core personality traits of psychopaths are exceedingly difficult to change, their criminal behaviors may prove more amenable to treatment.
Psychopathy reminds us that media depictions of mental illness often contain as much fiction as fact. Moreover, widespread misunderstandings of such ailments can produce unfortunate consequences-as Tony Soprano discovered shortly before the television screen went blank.
Jeffrey Dahmer. Ted Bundy. Hannibal Lecter. These are the psychopaths whose stunning lack of conscience we see in the movies and in tabloids. Yet, as this report makes abundantly clear, these predators, both male and female, haunt our everyday lives at work, at home, and in relationships. Here's how to find them before they find you.
She met him in a laundromat in London. He was open and friendly and they hit it off right away. From the start she thought he was hilarious. Of course, she'd been lonely. The weather was grim and sleety and she didn't know a soul east of the Atlantic.
"Ah, travelers' loneliness," Dan crooned sympathetically over dinner. "It's the worst."
After dessert he was embarrassed to discover he'd come without his wallet. She was more than happy to pay for dinner. At the pub, over drinks, he told her he was a translator for the United Nations. He was, for now, between assignments.
They saw each other four times that week, five the week after. It wasn't long before he had all but moved in with Elsa. It was against her nature, but she was having the time of her life.
Still, there were details, unexplained, undiscussed, that she shoved out of her mind. He never invited her to his home; she never met his friends. One night he brought over a carton filled with tape recordersÑplastic-wrapped straight from the factory, unopened; a few days later they were gone. Once she came home to find three televisions stacked in the corner. "Storing them for a friend," was all he told her. When she pressed for more he merely shrugged.
Once he stayed away for three days and was lying asleep on the bed when she came in midmorning. "Where have you been?" she cried. "I've been so worried. Where were you?"
He looked sour as he woke up. "Don't ever ask me that," he snapped. "I won't have it."
"WhatÑ?"
"Where I go, what I do, who I do it withÑit doesn't concern you, Elsa. Don't ask."
He was like a different person. But then he seemed to pull himself together, shook the sleep off, and reached out to her. "I know it hurts you," he said in his old gentle way, "but I think of jealousy as a flu, and wait to get over it. And you will, baby, you will." Like a mother cat licking her kitten, he groomed her back into trusting him.
One night she asked him lightly if he felt like stepping out to the corner and bringing her an ice cream. He didn't reply, and when she glanced up she found him glaring at her furiously. "Always got everything you wanted, didn't you?" he asked in a strange, snide way. "Any little thing little Elsa wanted, somebody always jumped up and ran out and bought it for her, didn't they?"
"Are you kidding? I'm not like that. What are you talking about?"
He got up from the chair and walked out. She never saw him again.
There is a class of individuals who have been around forever and who are found in every race, culture, society and walk of life. Everybody has met these people, been deceived and manipulated by them, and forced to live with or repair the damage they have wrought. These often charmingÑbut always deadlyÑindividuals have a clinical name: psychopaths. Their hallmark is a stunning lack of conscience; their game is self-gratification at the other person's expense. Many spend time in prison, but many do not. All take far more than they give.
The most obvious expressions of psychopathyÑbut not the only onesÑinvolve the flagrant violation of society's rules. Not surprisingly, many psychopaths are criminals, but many others manage to remain out of prison, using their charm and chameleon-like coloration to cut a wide swathe through society, leaving a wake of ruined lives behind them.
A major part of my own quarter-century search for answers to this enigma has been a concerted effort to develop an accurate means of detecting the psychopaths among us. Measurement and categorization are, of course, fundamental to any scientific endeavor, but the implications of being able to identify psychopaths are as much practical as academic. To put it simply, if we can't spot them, we are doomed to be their victims, both as individuals and as a society.
My role in the search for psychopaths began in the 1960s at the psychology department of the University of British Columbia. There, my growing interest in psychopathy merged with my experience working with psychopaths in prison to form what was to become my life's work.
I assembled a team of clinicians who would identify psychopaths in the prison population by means of long, detailed interviews and close study of file information. From this eventually developed a highly reliable diagnostic tool that any clinician or researcher could use and that yielded a richly detailed profile of the personality disorder called psychopathy. We named this instrument the Psychopathy Checklist (Multi-Health Systems; 1991). The checklist is now used worldwide and provides clinicians and researchers with a way of distinguishing, with reasonable certainty, true psychopaths from those who merely break the rules.
What follows is a general summary of the key traits and behaviors of a psychopath. Do not use these symptoms to diagnose yourself or others. A diagnosis requires explicit training and access to the formal scoring manual. If you suspect that someone you know conforms to the profile described here, and if it is important for you to have an expert opinion, you should obtain the services of a qualified (registered) forensic psychologist or psychiatrist.
Also, be aware that people who are not psychopaths may have some of the symptoms described here. Many people are impulsive, or glib, or cold and unfeeling, but this does not mean that they are psychopaths. Psychopathy is a syndromeÑa cluster of related symptoms.
Key Symptoms of Psychopathy
Emotional/Interpersonal:
Social Deviance:
Glib and Superficial
Psychopaths are often voluble and verbally facile. They can be amusing and entertaining conversationalists, ready with a clever comeback, and are able to tell unlikely but convincing stories that cast themselves in a good light. They can be very effective in presenting themselves well and are often very likable and charming.
One of my raters described an interview she did with a prisoner: "I sat down and took out my clipboard," she said, "and the first thing this guy told me was what beautiful eyes I had. He managed to work quite a few compliments on my appearance into the interview, so by the time I wrapped things up, I was feeling unusuallyÉ well, pretty. I'm a wary person, especially on the job, and can usually spot a phony. When I got back outside, I couldn't believe I'd fallen for a line like that."
Egocentric and Grandiose
Psychopaths have a narcissistic and grossly inflated view of their own self-worth and importance, a truly astounding egocentricity and sense of entitlement, and see themselves as the center of the universe, justified in living according to their own rules. "It's not that I don't follow the law," said one subject. "I follow my own laws. I never violate my own rules." She then proceeded to describe these rules in terms of "looking out for number one."
Psychopaths often claim to have specific goals but show little appreciation regarding the qualifications requiredÑthey have no idea of how to achieve them and little or no chance of attaining these goals, given their track record and lack of sustained interest in formal education. The psychopathic inmate might outline vague plans to become a lawyer for the poor or a property tycoon. One inmate, not particularly literate, managed to copyright the title of a book he was planning to write about himself, already counting the fortune his best-selling book would bring.
Lack of Remorse or Guilt
Psychopaths show a stunning lack of concern for the effects their actions have on others, no matter how devastating these might be. They may appear completely forthright about the matter, calmly stating that they have no sense of guilt, are not sorry for the ensuing pain, and that there is no reason now to be concerned.
When asked if he had any regrets about stabbing a robbery victim who subsequently spent time in the hospital as a result of his wounds, one of our subjects replied, "Get real! He spends a few months in hospital and I rot here. If I wanted to kill him I would have slit his throat. That's the kind of guy I am; I gave him a break."
Their lack of remorse or guilt is associated with a remarkable ability to rationalize their behavior, to shrug off personal responsibility for actions that cause family, friends, and others to reel with shock and disappointment. They usually have handy excuses for their behavior, and in some cases deny that it happened at all.
Lack of Empathy
Many of the characteristics displayed by psychopaths are closely associated with a profound lack of empathy and inability to construct a mental and emotional "facsimile" of another person. They seem completely unable to "get into the skin" of others, except in a purely intellectual sense.
They are completely indifferent to the rights and suffering of family and strangers alike. If they do maintain ties, it is only because they see family members as possessions. One of our subjects allowed her boyfriend to sexually molest her five-year-old daughter because "he wore me out. I wasn't ready for more sex that night." The woman found it hard to understand why the authorities took her child into care.
Deceitful and Manipulative
With their powers of imagination in gear and beamed on themselves, psychopaths appear amazingly unfazed by the possibilityÑor even by the certaintyÑof being found out. When caught in a lie or challenged with the truth, they seldom appear perplexed or embarrassedÑthey simply change their stories or attempt to rework the facts so they appear to be consistent with the lie. The result is a series of contradictory statements and a thoroughly confused listener.
And psychopaths seem proud of their ability to lie. When asked if she lied easily, one woman laughed and replied, "I'm the best. I think it's because I sometimes admit to something bad about myself. They think, well, if she's admitting to that she must be telling the truth about the rest."
Shallow Emotions
Psychopaths seem to suffer a kind of emotional poverty that limits the range and depth of their feelings. At times they appear to be cold and unemotional while nevertheless being prone to dramatic, shallow, and short-lived displays of feeling. Careful observers are left with the impression they are playacting and little is going on below the surface.
A psychopath in our research said that he didn't really understand what others meant by fear. "When I rob a bank," he said, "I notice that the teller shakes. One barfed all over the money. She must have been pretty messed up inside, but I don't know why. If someone pointed a gun at me I guess I'd be afraid, but I wouldn't throw up." When asked if he ever felt his heart pound or his stomach churn, he replied, "Of course! I'm not a robot. I really get pumped up when I have sex or when I get into a fight."
Impulsive
Psychopaths are unlikely to spend much time weighing the pros and cons of a course of action or considering the possible consequences. "I did it because I felt like it," is a common response. These impulsive acts often result from an aim that plays a central role in most of the psychopath's behavior: to achieve immediate satisfaction, pleasure, or relief.
So family members, relatives, employers, and coworkers typically find themselves standing around asking themselves what happenedÑjobs are quit, relationships broken off, plans changed, houses ransacked, people hurt, often for what appears as little more than a whim. As the husband of a psychopath I studied put it: "She got up and left the table, and that was the last I saw of her for two months."
Poor Behavior Controls
Besides being impulsive, psychopaths are highly reactive to perceived insults or slights. Most of us have powerful inhibitory controls over our behavior; even if we would like to respond aggressively we are usually able to "keep the lid on." In psychopaths, these inhibitory controls are weak, and the slightest provocation is sufficient to overcome them.
As a result, psychopaths are short-tempered or hotheaded and tend to respond to frustration, failure, discipline, and criticism with sudden violence, threats or verbal abuse. But their outbursts, extreme as they may be, are often short-lived, and they quickly act as if nothing out of the ordinary has happened.
For example, an inmate in line for dinner was accidentally bumped by another inmate, whom he proceeded to beat senseless. The attacker then stepped back into line as if nothing had happened. Despite the fact that he faced solitary confinement as punishment for the infraction, his only comment when asked to explain himself was, "I was pissed off. He stepped into my space. I did what I had to do."
Although psychopaths have a "hair trigger," their aggressive displays are "cold"; they lack the intense arousal experienced when other individuals lose their temper.
A Need for Excitement
Psychopaths have an ongoing and excessive need for excitementÑthey long to live in the fast lane or "on the edge," where the action is. In many cases the action involves the breaking of rules.
Many psychopaths describe "doing crime" for excitement or thrills. When asked if she ever did dangerous things just for fun, one of our female psychopaths replied, "Yeah, lots of things. But what I find most exciting is walking through airports with drugs. Christ! What a high!"
The flip side of this yen for excitement is an inability to tolerate routine or monotony. Psychopaths are easily bored and are not likely to engage in activities that are dull, repetitive, or require intense concentration over long periods.
Lack of Responsibility
Obligations and commitments mean nothing to psychopaths. Their good intentionsÑ"I'll never cheat on you again"Ñare promises written on the wind.
Horrendous credit histories, for example, reveal the lightly taken debt, the loan shrugged off, the empty pledge to contribute to a child's support. Their performance on the job is erratic, with frequent absences, misuse of company resources, violations of company policy, and general untrustworthiness. They do not honor formal or implied commitments to people, organizations, or principles.
Psychopaths are not deterred by the possibility that their actions mean hardship or risk for others. A 25-year-old inmate in our studies has received more than 20 convictions for dangerous driving, driving while impaired, leaving the scene of an accident, driving without a license, and criminal negligence causing death. When asked if he would continue to drive after his release from prison, he replied, "Why not? Sure, I drive fast, but I'm good at it. It takes two to have an accident."
Early Behavior Problems
Most psychopaths begin to exhibit serious behavioral problems at an early age. These might include persistent lying, cheating, theft, arson, truancy, substance abuse, vandalism, and/or precocious sexuality. Because many children exhibit some of these behaviors at one time or anotherÑespecially children raised in violent neighborhoods or in disrupted or abusive familiesÑit is important to emphasize that the psychopath's history of such behaviors is more extensive and serious than most, even when compared with that of siblings and friends raised in similar settings.
One subject, serving time for fraud, told us that as a child he would put a noose around the neck of a cat, tie the other end of the string to the top of a pole, and bat the cat around the pole with a tennis racket. Although not all adult psychopaths exhibited this degree of cruelty when in their youth, virtually all routinely got themselves into a wide range of difficulties.
Adult Antisocial Behavior
Psychopaths see the rules and expectations of society as inconvenient and unreasonable impediments to their own behavioral expression. They make their own rules, both as children and as adults.
Many of the antisocial acts of psychopaths lead to criminal charges and convictions. Even within the criminal population, psychopaths stand out, largely because the antisocial and illegal activities of psychopaths are more varied and frequent than are those of other criminals. Psychopaths tend to have no particular affinity, or "specialty," for one particular type of crime but tend to try everything.
But not all psychopaths end up in jail. Many of the things they do escape detection or prosecution, or are on "the shady side of the law." For them, antisocial behavior may consist of phony stock promotions, questionable business practices, spouse or child abuse, and so forth. Many others do things that, though not necessarily illegal, are nevertheless unethical, immoral, or harmful to others: philandering or cheating on a spouse to name a few.
Origins
Thinking about psychopathy leads us very quickly to a single fundamental question: Why are some people like this?
Unfortunately, the forces that produce a psychopath are still obscure, an admission those looking for clear answers will find unsatisfying. Nevertheless, there are several rudimentary theories about the cause of psychopathy worth considering. At one end of the spectrum are theories that view psychopathy as largely the product of genetic or biological factors (nature), whereas theories at the other end posit that psychopathy results entirely from a faulty early social environment (nurture).
The position that I favor is that psychopathy emerges from a complexÑand poorly understoodÑinterplay between biological factors and social forces. It is based on evidence that genetic factors contribute to the biological bases of brain function and to basic personality structure, which in turn influence the way an individual responds to, and interacts with, life experiences and the social environment. In effect, the core elements needed for the development of psychopathyÑincluding a profound inability to experience empathy and the complete range of emotions, including fearÑare in part provided by nature and possibly by some unknown biological influences on the developing fetus and neonate. As a result, the capacity for developing internal controls and conscience and for making emotional "connections" with others is greatly reduced.
Can Anything Be Done?
In their desperate search for solutions people trapped in a destructive and seemingly hopeless relationship with a psychopath frequently are told: Quit indulging him and send him for therapy. A basic assumption of psychotherapy is that the patient needs and wants help for distressing or painful psychological and emotional problems. Successful therapy also requires that the patient actively participate, along with the therapist, in the search for relief of his or her symptoms. In short, the patient must recognize there is a problem and must want to do something about it.
But here is the crux: Psychopaths don't feel they have psychological or emotional problems, and they see no reason to change their behavior to conform with societal standards they do not agree with.
Thus, in spite of more than a century of clinical study and decades of research, the mystery of the psychopath still remains. Recent developments have provided us with new insights into the nature of this disturbing disorder, and its borders are becoming more defined. But compared with other major clinical disorders, little research has been devoted to psychopathy, even though it is responsible for more social distress and disruption than all other psychiatric disorders combined.
So, rather than trying to pick up the pieces after the damage has been done, it would make far greater sense to increase our efforts to understand this perplexing disorder and to search for effective early interventions. The alternatives are to continue devoting massive resources to the prosecution, incarceration, and supervision of psychopaths after they have committed offenses against society and to continue to ignore the welfare and plight of their victims. We have to learn how to socialize them, not resocialize them. And this will require serious efforts at research and early intervention. It is imperative that we continue the search for clues.
A Survival Guide
Although no one is completely immune to the devious machinations of the psychopath, there are some things you can do to reduce your vulnerability.
Unfortunately, even the most careful precautions are no guarantee that you will be safe from a determined psychopath. In such cases, all you can do is try to exert some sort of damage control. This is not easy but some suggestions may be of help:
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