“Suddenly, everything made sense, I was not crazy, I had been dealing with a psychopath!” explained a woman this week as she told the story of how she discovered “psychopathy” and Dr. Hare’s diagnostic symptoms. With this discovery, she learned that a personality disorder is behind the behavior of people who manipulate and harm others without guilt or remorse. Prior to learning about psychopathy, the woman said she held the view that all people were basically good and needed the same things. Understanding psychopathy/sociopathy gave her the ability to make sense of a world where a small fraction of individuals do a tremendous amount of harm- AND YET THESE INDIVIDUALS ON THE SURFACE SEEM PERFECTLY NORMAL.
As we discussed the kidnapping of Jaycee Lee Dugard, that same woman questioned whether Phillip Garrido (the kidnapper) is “a psychopath.” She tended to think that Garrido, “Is not a psychopath” and that schizophrenia or some delusional disorder was behind Garrido’s monstrous behavior. According to my friend, “a psychopath” is not mentally ill, is in contact with reality, and yet perpetrates evil anyway. For her the appearance of sanity is an essential characteristic of a psychopath/sociopath.
This week I want to discuss Garrido, and Brian David Mitchell (Elizabeth’s Smart’s kidnapper). These two men are strikingly similar. But first I have to tell you about my own moment of awakening with regard to psychopathy. Just like my friend’s moment, my moment made sense of the world, however it came after years of experience with antisocial people and after years of reading about the disorder. In my moment I realized that psychopathy explains evil.
Yes, I said psychopathy explains evil. This statement is true even though people who are not “psychopaths” do plenty of evil. Because psychopathy explains evil, its importance extends far beyond enabling us to identify the most recidivist criminals, or those who we should avoid going on dates with.
How did it come to pass that psychopathy explains evil? My friend is correct in that originally psychopathy (more than 100 years ago) was called “moral insanity.” It was conceived of as a disorder where people who have an intact mind repeatedly violate the rights of others. Then, Dr. Hervey Cleckley intensively studied the case histories of those he believed to be “psychopaths.” From his experience with many cases Dr. Cleckley developed a list of traits he believed could be used to identify those with the disorder.
Dr. Robert Hare took those traits and used them, along with other personality disorder criteria to develop the PCL-R which is now the best way to “diagnose psychopathy.” Forensic professionals have administered the PCL-R to thousands of offenders and to people with substance abuse issues. From these studies we know that “psychopathy” is actually not a category it is a continuum. In fact the PCL-R scores of offenders are all markedly elevated above those of general population samples (like college students). There is no absolute cut-off score that identifies “true psychopaths.” Instead, for every point increase in score the risk of doing evil increases. The PCL-R is a very good measure of an individual’s risk to offend against others and society.
Psychopathy, as currently measured by the PCL-R is then a trait that is present in everyone to a greater or lesser degree. This trait cuts across diagnostic categories. Think of it like you would intelligence as measured by IQ tests. Everybody has an IQ but it is only when the scores are very high or very low that they come to define or categorize a person. Psychopaths are the equivalent of geniuses who score so high and are so different from average that this difference becomes a defining quality.
Scientists use a cut score of 25-30 on the PCL-R to identify and study “psychopaths.” When studying psychopaths scientists exclude from their studies people who also have other obvious defining qualities like mental retardation and delusions/hallucinations. By looking at the “pure” top end of the distribution they can study those who are most prone to doing evil and try to determine the brain disorder that underlies doing evil. People at the top end are more likely to be measurably different from other people.
Since the psychopaths researchers study are free from other disorders, any brain findings can be attributed to psychopathy. In such studies, several brain abnormalities have been found and linked to the behavior of psychopaths. The brain regions found to be abnormal in psychopaths are those regions demonstrated to be responsible for moral loving conduct in all of us. Abnormalities are also seen in those regions where aggressive impulses originate.
Again, using the analogy of intelligence, if we study what makes geniuses smart we learn something about what makes the average person smart. When we study what is wrong with psychopaths we learn something about what causes all of us to express and act on aggressive impulses.
In broader studies, scientists have discovered that the people who score over 25 on the PCL-R are a diverse group. While they share the symptoms of psychopathy, they may differ in important ways including the presence of other psychiatric disorders and mental retardation. Some psychopaths are also mentally ill above and beyond the psychopathy. Some experience delusions, particularly grandiose delusions and some hallucinate. There are many people who have delusions and hallucinations and yet do not harm others because psychotic disorders usually do not impair the moral brain, and the content of their delusions or hallucinations does not produce aggression.
Both psychotic and non-psychotic psychopaths experience increased impulses to harm others and they lack the moral brain mechanisms to restrain these impulses. That gets me to Garrido and Mitchell. Both men have grandiose delusions and have impaired contact with reality. However, both were organized enough to plan and carry out kidnapping and sexual assault. (This is actually evidence for psychopathy since psychopathy has been linked to sexual assault and sexual perversion in many studies.)
Both Garrido and Mitchell are also psychopathic enough so that the cries and suffering of their victims and their victim’s families meant nothing. Both remain self absorbed and have failed to show any real remorse for their actions. In fact, Garrido said in one of his news interviews that we would all come to see his story as “heart warming.” It makes intuitive sense that if a psychopath were to develop delusions, they would be of a grandiose nature since grandiosity is part of the disorder. The psychosis just exaggerates what is already there. Similarly when psychopaths hallucinate, they hear voices that tell them how wonderful and special they are. Of course G-d and angels talk to them!
In summary, I believe Garrido and Mitchell are both highly psychopathic. They both have disorders in multiple brain systems, including those important in reality orientation and those involved in the generation and inhibition of aggressive sexual impulses. One of my supervisors called such individuals schizopaths (combined schizophrenia and psychopathy). Schizopaths are the most dangerous individuals in our society because they have no restraint over the impulses generated by the psychotic process.
On this blog, we have talked about the need for laws to protect society from psychopaths. In my opinion, it makes sense to start with schizopaths. Offenders identified with both psychotic and psychopathic tendencies should be considered a special group. After even one serious offense, these individuals should be kept incarcerated or hospitalized to protect the public. One strike you’re out is justified because of the chronic nature of combined psychopathy and psychosis.
Next week, the female accomplices of Garrido and Mitchell.