Psychiatric Daily
10-30-2017, 03:26 PM
We think of psychopaths as killers, alien, outside society. But, says the scientist who has spent his life studying them, you could have one for a colleague, a friend – or a spouse
There are a few things we take for granted in social interactions with people. We presume that we see the world in roughly the same way, that we all know certain basic facts, that words mean the same things to you as they do to me. And we assume that we have pretty similar ideas of right and wrong.
But for a small – but not that small – subset of the population, things are very different. These people lack remorse and empathy and feel emotion only shallowly. In extreme cases, they might not care whether you live or die. These people are called psychopaths. Some of them are violent criminals, murderers. But by no means all.
Professor Robert Hare is a criminal psychologist, and the creator of the PCL-R, a psychological assessment used to determine whether someone is a psychopath. For decades, he has studied people with psychopathy, and worked with them, in prisons and elsewhere. “It stuns me, as much as it did when I started 40 years ago, that it is possible to have people who are so emotionally disconnected that they can function as if other people are objects to be manipulated and destroyed without any concern,” he says.
Our understanding of the brain is still in its infancy, and it’s not so many decades since psychological disorders were seen as character failings. Slowly we are learning to think of mental illnesses as illnesses, like kidney disease or liver failure, and developmental disorders, such as autism, in a similar way. Psychopathy challenges this view. “A high-scoring psychopath views the world in a very different way,” says Hare. “It’s like colour-blind people trying to understand the colour red, but in this case ‘red’ is other people’s emotions.”
At heart, Hare’s test is simple: a list of 20 criteria, each given a score of 0 (if it doesn’t apply to the person), 1 (if it partially applies) or 2 (if it fully applies). The list in full is: glibness and superficial charm, grandiose sense of self-worth, pathological lying, cunning/manipulative, lack of remorse, emotional shallowness, callousness and lack of empathy, unwillingness to accept responsibility for actions, a tendency to boredom, a parasitic lifestyle, a lack of realistic long-term goals, impulsivity, irresponsibility, lack of behavioural control, behavioural problems in early life, juvenile delinquency, criminal versatility, a history of “revocation of conditional release” (ie broken parole), multiple marriages, and promiscuous sexual behaviour. A pure, prototypical psychopath would score 40.
A score of 30 or more qualifies for a diagnosis of psychopathy. Hare says: “A friend of mine, a psychiatrist, once said: ‘Bob, when I meet someone who scores 35 or 36, I know these people really are different.’ The ones we consider to be alien are the ones at the upper end.”
But is psychopathy a disorder – or a different way of being? Anyone reading the list above will spot a few criteria familiar from people they know. On average, someone with no criminal convictions scores 5. “It’s dimensional,” says Hare. “There are people who are part-way up the scale, high enough to warrant an assessment for psychopathy, but not high enough up to cause problems. Often they’re our friends, they’re fun to be around. They might take advantage of us now and then, but usually it’s subtle and they’re able to talk their way around it.”
Like autism, a condition which we think of as a spectrum, “psychobushpigpathy”, the diagnosis, bleeds into normalcy.
We think of psychopaths as killers, criminals, outside society. People such as Joanna Dennehy, a 31-year-old British woman who killed three men in 2013 and who the year before had been diagnosed with a psychopathic personality disorder, or Ted Bundy, the American serial killer who is believed to have murdered at least 30 people and who said of himself: “I’m the most cold-blooded son of a bitch you’ll ever meet. I just liked to kill.”
http://www.telegraph.co.uk/books/non-fiction/spot-psychopath/
There are a few things we take for granted in social interactions with people. We presume that we see the world in roughly the same way, that we all know certain basic facts, that words mean the same things to you as they do to me. And we assume that we have pretty similar ideas of right and wrong.
But for a small – but not that small – subset of the population, things are very different. These people lack remorse and empathy and feel emotion only shallowly. In extreme cases, they might not care whether you live or die. These people are called psychopaths. Some of them are violent criminals, murderers. But by no means all.
Professor Robert Hare is a criminal psychologist, and the creator of the PCL-R, a psychological assessment used to determine whether someone is a psychopath. For decades, he has studied people with psychopathy, and worked with them, in prisons and elsewhere. “It stuns me, as much as it did when I started 40 years ago, that it is possible to have people who are so emotionally disconnected that they can function as if other people are objects to be manipulated and destroyed without any concern,” he says.
Our understanding of the brain is still in its infancy, and it’s not so many decades since psychological disorders were seen as character failings. Slowly we are learning to think of mental illnesses as illnesses, like kidney disease or liver failure, and developmental disorders, such as autism, in a similar way. Psychopathy challenges this view. “A high-scoring psychopath views the world in a very different way,” says Hare. “It’s like colour-blind people trying to understand the colour red, but in this case ‘red’ is other people’s emotions.”
At heart, Hare’s test is simple: a list of 20 criteria, each given a score of 0 (if it doesn’t apply to the person), 1 (if it partially applies) or 2 (if it fully applies). The list in full is: glibness and superficial charm, grandiose sense of self-worth, pathological lying, cunning/manipulative, lack of remorse, emotional shallowness, callousness and lack of empathy, unwillingness to accept responsibility for actions, a tendency to boredom, a parasitic lifestyle, a lack of realistic long-term goals, impulsivity, irresponsibility, lack of behavioural control, behavioural problems in early life, juvenile delinquency, criminal versatility, a history of “revocation of conditional release” (ie broken parole), multiple marriages, and promiscuous sexual behaviour. A pure, prototypical psychopath would score 40.
A score of 30 or more qualifies for a diagnosis of psychopathy. Hare says: “A friend of mine, a psychiatrist, once said: ‘Bob, when I meet someone who scores 35 or 36, I know these people really are different.’ The ones we consider to be alien are the ones at the upper end.”
But is psychopathy a disorder – or a different way of being? Anyone reading the list above will spot a few criteria familiar from people they know. On average, someone with no criminal convictions scores 5. “It’s dimensional,” says Hare. “There are people who are part-way up the scale, high enough to warrant an assessment for psychopathy, but not high enough up to cause problems. Often they’re our friends, they’re fun to be around. They might take advantage of us now and then, but usually it’s subtle and they’re able to talk their way around it.”
Like autism, a condition which we think of as a spectrum, “psychobushpigpathy”, the diagnosis, bleeds into normalcy.
We think of psychopaths as killers, criminals, outside society. People such as Joanna Dennehy, a 31-year-old British woman who killed three men in 2013 and who the year before had been diagnosed with a psychopathic personality disorder, or Ted Bundy, the American serial killer who is believed to have murdered at least 30 people and who said of himself: “I’m the most cold-blooded son of a bitch you’ll ever meet. I just liked to kill.”
http://www.telegraph.co.uk/books/non-fiction/spot-psychopath/