With the release of the Mask of Sanity in the 1940s Dr. Hervey Cleckley began the quest to describe a syndrome called psychopathy, in which affected individuals prey on others without remorse. Since people affected by the syndrome are socially disordered the syndrome has also been called sociopathy. Dr. Robert Hare extended the work of Cleckley and carefully documented the symptoms of the disorder. All this research has lead to two basic conclusions:
1. It is quite remarkable that individuals who choose a lifestyle of remorseless predation of other people are so similar in their behaviors and personality traits.
2. Equally important is the idea that non-disordered people do not “regularly” prey on others.
These two very profound conclusions have been the cause of a dilemma that is outlined by the following statement by a prominent psychopathy researcher:
Clearly, not all people who are violent or callous or sadistic are psychopathic. In fact, it is probably the case that most of the cruelty in the world is not perpetrated by psychopathic individuals. Similarly, although psychopaths commit a disproportionate share of the violent crime, it seems to me that they do not commit even the majority of the violent crime.
Over the last two weeks I have thought about the above dilemma, particularly since attending the Battered Mothers Custody Conference. The dilemma was also discussed at the conference in the form of questioning whether “all batters are psychopaths/sociopaths.” I want to answer this question for you in and extend the answer to the broader context of psychopathy/sociopathy and humanity.
All though I have the utmost respect for the quoted psychopathy researcher, I disagree strongly with his views. I believe that ALL people who are violent, callous or sadistic (in the sense that these traits persist in them) are psychopathic.
Over the last 7 years a number of studies show that the group of traits and behaviors that group together in psychopathy act like a “dimensional trait.” By dimensional trait I mean that psychopathy is similar to height. Just as there are short people and tall people and also what we consider short and tall changes according to age, gender and geography, there are people who are more or less psychopathic. The dilemma only happens when we attempt to categorize a person and call him or her “a psychopath/sociopath.” Scientists and mental health professionals disagree about where to draw the dividing line to indicate “a psychopath,” just like you and I might disagree as to what height makes for a “tall person.”
The dimension, psychopathic is also different from height in a very important respect- that is stability. Whereas height is very stable, psychopathy is only relatively stable and is affected by aging, mood disorders, substance abuse and social environment.
Now I want to explain the source of the confusion around the dimension psychopathic. The source of the confusion is a failure to understand that one issue underlies psychopathy and is the cause of the observed fact that a group of traits and behaviors cluster together in psychopathy/sociopathy.
The cause of psychopathy/sociopathy is an addiction to power. The addiction to power can start at any age but as in most addictions it usually begins by the early 20s. Also like other addictions, the earlier a person becomes addicted to power, the worse the addiction. Addictions that begin early are very resistant to treatment and carry a very poor prognosis. Psychopathy/sociopathy that starts prior to age 10 (puberty) is the most devastating.
The idea that an addiction to power underlies psychopathy/sociopathy has important micro and macro implications for human society. On a micro level the family is affected by psychopathic individuals who are obsessed with the pursuit of interpersonal power at the expense of family members. Violence, callous manipulation and sadism are all part of that power fix. The person that abuses family members does so because it makes him or her feel powerful. That is true whether the abuser is mother, father, brother, sister or any other relation.
The macro level is just as important. Our institutional leaders, if addicted to power produce widespread abuse in our society. Institutional leaders are bosses, politicians, teachers and the like. When we examine risk for “psychopathy” in leaders, it is useful to consider the phenomenon of addiction as applied to power.
Last night we went to The Cheesecake Factory to celebrate my daughter’s 18th birthday. I had one frozen mango marguerita, likely one of six I will have in all of 2009. I will also likely drink 4 glasses of wine and about three beers all year. There are many people who cannot drink just one drink because the pleasure of alcohol sets off a chemical reaction in their brains. Once they have one drink they develop a compulsion to keep drinking.
Power with me works the same way. I dislike telling other people what to do. I have had to learn to manage this dislike in order to adequately mother my children. Good parenting requires the thoughtful, careful exertion of interpersonal power. Some parents become addicted to that power and become what are called “authoritarian parents.” They are so bossy and dictatorial their poor children never learn to think for themselves.
Institutional leaders are like parents. Leadership requires thoughtful, careful exertion of interpersonal power. For a psychopathic, power-addict the first time they lead the meeting fills them with pleasure and delight. They become obsessed with the feeling and so obsessed with power. Since love and power motives are mutually exclusive, eventually power consumes the person’s entire being and he/she develops all the qualities of “a psychopath.”
Let us look at domestic violence again. Men and women who abuse their partners mentally, emotionally sexually and physically are not normal people who are the subjects of the influence of a violent society. They are power addicts. Just like there are societal factors in alcoholism, gambling and other addictions, there are societal influences on psychopathy. These societal influences no more cause psychopathy or power addiction, than they do alcoholism. Drinking causes alcoholism and exerting power causes psychopathy- in people with an inborn predisposition.
Please comment on what I have written. If you disagree please state your reasons. Let’s have a debate.
Last night and this morning, I watched someone process a blatant betrayal by someone he thought was his friend. He asked me to come talk with him, to get another opinion on what had happened, and what he was feeling. He needed validation that he’d been wronged, and validation of his feelings of betrayal and grief.
Now, this guy looks like one of the biggest, toughest dudes on the street. But behind the exterior, he’s got a big heart, and he’ll help out anyone he can. He had let the betrayer into his home (does this sound familiar, anyone?), and fed him, listened to him, and treated him like family. Yesterday the couch surfer surfed on over to Big Dude’s ex-wife’s home. The same ex-wife who has been pulling a lot of manipulative, destructive, lying, chaos-inducing behaviors both during their marriage and in the three years after the divorce. Can you sense his profound shock at the turnabout of the turncoat?
In the grand picture of all the experiences we share here in LF, and all the rape, pillage, and wreckage we’ve lived through, this story is relativey minor. At least the part about the betrayal of the so-called buddy. I see the hurt in his eyes, and I understand. And as I’m writing, I’m wondering if he’s even more sensitive to this betrayal because of the colossal betrayals perpetrated by his ex-wife, both in and out of the marriage. It’s a re-wounding of the same scar tissue.
Is the couch surfer a P? an S? an N? or just a “dirt bag!” I do know that Big Dude trusted his old buddy, and he’s deeply hurt by the violation of that trust.
Now, would a therapist understand why this event hurts so much? Without having a real understanding of the pain of betrayal, I doubt it.
Jen
I think that it would be unethical for any therapist to “diagnose” an absent party, no matter how much anecdotal evidence there is.
The therapist always works only with the person in the room, as that is really the only thing that can be done.
ASPD has a very poor prognosis. I am sure that if you tested an entire prison population, 90 % would be ASPD.
ASPD is NOT insanity, as you are still responsible for your crimes. Lets face it, if you have raped or murdered someone, you are definately not very sociable.
Also, if you look at therapy from the therapists perpective, very few would want to work with something they no nothing about. Just as a brain surgeon doesnt remove toncils, even though they probably could. It just isnt gratifying for a therapist to work with someone they cant really help. Therapists are like everyone else – they also want a feeling of job satisfaction.
Grant
What my psychiatrist said is “I think we can safely agree this is a guy who is looking out for himself. And so much so, that I can guarantee you that any further contact with him, positive or negative, is going to hurt you.” He didn’t have to label the person. One therapist said “Have you ever considered that he may be a sex addict?” I had suspected that was another of his problems, but thought I really didn’t know much about how one acts, so it was SO validating to have her say it. One said simply “This relationship is toxic for you. He is incapable of intimacy, of a reciprocal relationship, of love.” They don’t have to label to tell you what is what.
Yes, I agree, it is validating.
I wouldnt dare describe someone as a “Anti-Social” if I hadnt assessed them, however,and didnt have test results to back me up. If I were asked in court to justify myself, Id need test results.
Also, think how you’d feel if a friend or lovers therapist diagnosed you after hearing about an incident third hand. It isnt really fair, even if it helps.
Grant & JAH: There are legitimate evaluation tools that use third-party reports to assess an individual. In the case of a pathological liar, you might consider that third-party reports are likely to be more accurate.
When Liane Leedom and Sandra Brown did their research for “Women Who Love Psychopaths” they used a modified version of a research tool to allow the women responding to be able to answer questions that described their partners.
In addition, in the book “The Socially Skilled Child Molester,” the author makes the point that the best way of evaluating whether a “groomer” child molester is working in the community is by third parties comparing notes and validating their concerns.
This might make us a little queasy when we think of how this might be abused, but — again — consider that we are evaluating pathological liars.
Grant,
My therapist didn’t diagnosis anyone as anything. She asked me what *I* thought. It was validating to have her give ME permission to label him. And if the courts asked me what I based that on, I’d have a WHOLE LOT to tell them!!!
I wouldn’t care what a therapist for someone else said I was. I would understand it is based on “IF what I’m hearing is true, and IF I’m getting a complete picture here, then this is not a person capable of X. Or this is a person who might do this or that.”
My therapist recently said “Alcoholics will do x, x, and x to you”. She was referring to the fact that I have told her my husband is an alcoholic. I may be telling a big fat lie! But based on her interactions with me, she has no reason to believe I’m telling her a lie and if she can’t give me advice on how to deal with what I’m facing, based on the assumption he IS an alcoholic, then I’m wasting my time and money going to see her. But I don’t think she is being unethical or unfair.
Anyway, I guess my point is (thought I’m not making it well at all!) is that I think therapists tend to NOT label, but they DO tell you if you are dancing a toxic dance, and if you are heaping blame on yourself that you don’t deserve. And so they can effective help without labeling, but if you JUST AREN”T GETTING IT, that you are being exploited, then sometimes they have to be a bit more direct, and if they get hauled into court they will just admit they have no evidence other than what their client told them, but yes, they labeled the man “an abuser” or whatever.
I agree that therapists have to be careful about labeling someone who is not present , for many reasons including how what they say might be repeated or used. They are only getting one side of the story, but as JAH said they can evaluate its potential for accuracy….maybe!
The fact that emotional wounds are invisible is the sticking point making both an opinion about another, and an evaluation of a client difficult. If we walked in with a black eye, a broken arm, and our ribs kicked in, they might have a more accurate picture and they might not hesitate to use labels. We can only describe emotional pain and the devastation that accompanies catastrophic loss, we can’t paint a picture of it for them. Even if we could, everyone’s picture would be different, so how do you standardize either a label or a diagnosis for what a victim feels and goes through?
Well, although a therapist cannot give a diagnosis without evaluating the actual person, I believe they can give an “opinion” after they have talked with you enough and gathered enough information, as long as they make it clear it is ONLY an opinion of possibilities based on the info they have. Even Hare tells you if you think you may be involved with a psychopath to contact a forensic psychologist or forensic psychiatrist, or contact several of them if you can afford it, so you can get SEVERAL OPINIONS. I’m assuming he specifies forensic because they are probably trained in the usage of the PCL-R and would be more likely to have actually dealt with psychopaths (but I’m just guessing)
And of course, the P-scan is a third party layman type evaluation of a persons possible psychopathic traits, and if the third party scores the person above 30 (scores can range from 0 to 60) on the P-scan that is considered cause for serious concern the person may have psychopathic traits. BUT the P-scan is NOT a diagnosis of psychopathy, but a tool to be used to determine IF a person appears to have enough psychopathic traits that they should be referred for further evaluation. I believe it is the P scan that Brown and Leedom used in trying to determine if the women were likely involved with psychopaths. But the P-scan is NOT a diagnosis even in their study, as all the P-scan did was indicate a person appeared to have enough qualifiers that they needed to be evaluated by a professional to determine if they might be psychopathic.
But with that said, my ex scored out a 52 on the P-scan and I actually put a question mark on a couple of the questions. I don’t care what he would “formally” be diagnosed as if he ever lands in a psychiatrists office, as he is still bad news regardless of what the formal diagnosis would actually be.
And I actually think it would be good if therapist used the P scan when they are dealing with victims of possible psychopaths, as long as they make clear the P scan is just a TOOL that indicates POSSIBLE psychopathy and that the person would actually have to be formally evaluated to get an actual diagnosis. At least with the P scan you get some sort of idea as to what “could” possibly be wrong, or NOT, and everyone is sort of on the same page as far as criteria used.
Wow! You guys have made some great “arguments” today while I was off working! My sons and I staggered to the house today after processing the meat of a cow and a bull calf, ate a Pizza and I slept 4 hours, now I am awake again and reenergized so I guess I’m here for a while!
The ONLY way anyone can be “legally” diagnosed is for them to be evaluated by a person with the proper credentials, usually a psychiatrist. That doesn’t mean a layman can’t say “he SEEMED depressed” or he “SEEMED to meet the criteria of psychopath” from MY PATIENT’s persepective. The person doing the comparison may or may not have the credentials for a “diagnosis” but they can have an OPINION.
Anytime you go to a therapist and you have relationship problems and the person(s) you are having relationship problems with is not there in therapy for you,, the therapist must go on YOUR assessment of the situation and the report of the events taking place. If your mother is even dead for example and you are telling the therapist about the troubled relationship you had with her, the therapist must make some sort of estimation (from your report) of what the problem was, and what your mother was like. The therapist might suggest that your mother was bi-polar from your description, which might not have occured to you especially if you weren’t a medical or MH person.
I have an ex-friend that I unofficially diagnose as OCD with high anxiety and kleptomania. She has described to me her mother and their relationship and I pretty well have her mom “psyched out” though I have never met the woman. I have had to essentially NC my ex-friend because she is continually “taking things” when she is around my place.
The first time she did this I was outraged and angry as what she took had no real monetary value but was a family heirloom. To this day she still denies it, but I have come to terms with this woman, no longer feel “betrayed.” She knew she was taking things that didn’t belong to her, but I realize her anxiety was so high she felt compelled to. I actually love this woman and her husband who have been very good friends of our family for 15 years, however, I can’t have her on my farm because she “takes things”. So, if there is ever any reason for her to come here, she has to be monitored by one of us, and she is never out of our sight.
Since the boundary is that she must give 24 hours notice before coming, I even clean out everything out of the bathroom she would use. LOL
I used to have a difficult time confronting her (back to my “don’t upset anyone no matter what they do”) and have now set very strict boundaries for this woman and she does not come around very often. If I totally NC her, I would lose contact with her husband and I really would not like that, but if it ever come to where I must totally NC her I would, but with very strict boundaries, I can associate with her on a limited basis.
I also have some empathy for her, but I do realize I have a right to set these boundaries and I no longer waffle about setting them, and if she gets upset too bad. Those are my boundaries.
She found a neurologist who keeps her supplied with valium and other similar drugs instead of being referred to a psychiatrist where I think she really needs to go, so her problem is not and never will be treated because she refuses to believe she has any psych issues. (BTW, her controlling mom makes mine look like the tooth fairy!)
When you sit and listen to your friend tell you about how her husband drinks, cheats, steals, gambles, and beats her up, you can get a pretty good idea he is a psychopath without having a PhD. Would it hold up in court? Nah, not likely, but you can sure make a case for a presumptive “diagnosis.”
IF IT LOOKS LIKE A DUCK, QUACKS LIKE A DUCK, AND LAYS EGGS……it might be a DUCK!
Then there are people who are psychopaths who have “two personalities”—one for private consumption and one for public consumption. Madoff is probably one of those. Ted Bundy was one of those. BTK killer was one of those, although I bet his wife kknew he was an “a$$H0le.”
ONe “fairly famous” child molester that I personally knew, knew his family, (we all lived in the same small town of 3,500) Charles “Jackie” Walls III. Jackie was definitely a “jerk” and his father was a very honest good small town attorney, who was very bright (he was Patton’s legal aid in WWII) anyway, Jackie who was a “Boy Scout Leader” for 20 years molested over 1500 kids during that period. ONe of them told his family and Jackie ordered the kid to kill them, which the kid did and got caught, and the story came out. Jackie had also molested one of his nephews, who later committed suicide. So Jackie was responsible for 4 deaths and 1500 kids who were molested.
Jackie worked with my X husband and I knew him through his father and the small town. I never liked Jackie, but NEVER in the wildest dreams realized his “private” personality, just his public one–though, again, I didn’t like the public one either.
The DA in his case stated on a 1 hour TV show about his case that if they could have asked for the death penalty in his case, they would have. How many lives and how many psyches did this man “kill”? Personally, if they had the death penalty, I would pull the trap myself as they hung him, but I think I would have a long line of people in front of me. I can only slightly imagine how much his father suffered. I thank God that Jackie’s mom died before it all came out.
In one of her books about child molesters that I read, Dr. Anna Salter wrote some statistics about child molesters and the HUNDREDS AND THOUSANDS of crimes that they EACH commit. They are pretty well NOT treatable. In MY OPINION ALL Child molesters are psychopaths….who are also not treatable and have no remorse.
In our society we have a group of people who go in and out of jail/prison like a revolving door for various crimes and criminal lifestyles. Are all or even most of these people psychopaths? Hare says 20% of them. I think the statistics for violent crime by this 20% is about 70+% so if that is the case, if we ONLY identified the 20% of criminals who are psychopaths and incarcerated these people for life in (I would suggest) special prisons built just for them, to keep them away from the other prisoners who are not psychopaths, but just “jerks” and “crooks” so they wouldn’t teach them worse things or prey on them either. With a 3-strikes law, these people should pretty well be singled out of the population, kept separate, the money for future prosecutions saved, and at least society at large would be protected from their crimes. I twould also have the added advantage that while they were incarcerated they would not be passing on more of their genetic material.
Of all the things I have seriously thought about to do with the psychopaths (in general) the 3-strikes laws would be the most realistic, IMHO.
Most of our (LF blogger’s) Ps would not fit into this catagory as they skirt around or under the law, but my son, and the Trojan HOrse Psychopath would qualify for a life sentence without parole. Most of my P-son’s “friends” he has made in prison would also be “qualified.”
What to do with or about the “garden variety” P who does not ommit felonies?????? I am not sure, on that, until further notice I think the “branding” with a hot iron on the forehead would work. Actually, in many places in the 1600s, 1700s etc. they did this, but the gentry got to be “branded” with a COLD iron. LOL The poor guy got the hot iron and a T was branded on him for “thief.” It did warn others though.
I also like the idea of the stocks and the ducking stool which is a good old American tradition brought over from England. LOL
So, Oxy, you want to “bell the cat”?