What does the psychopath ‘do’ with this diagnosis?

LoveFraud reader buzzibee raises some important issues in a recent comment.

How does a tested and proven psychopath usually respond to being told “You have a mental disorder. You are characteristically a psychopath”?

Are [they] so arrogant to dispute a medical diagnosis that they have a mental disorder? Do they display any desire to learn more about the disorder and at any point admit to it?

In order to be diagnosed as a psychopath, a person needs a score of 30 out of a possible 40 on the Psychotherapy Checklist-Revised test (PCL-R). This is a very time-consuming test which only trained personnel can administer, so by and large only prisoners and research subjects are likely to have it.

Psychopaths don’t see themselves as having a problem and so wouldn’t present themselves for testing anyway. Unless they thought they might benefit from the diagnosis in some way. So that’s point number one: psychopaths are unlikely to receive the diagnosis unless they are incarcerated, and probably not even then.

Point number two is that those who do get the diagnosis respond like psychopaths; in other words they use it as yet another tool to manipulate others. Here’s a quote from a December, 13 ‘Nature’ article on research scanning the brains of psychopaths in order to better understand empathy:

All the subjects seem to find the experiment to be nonsense. “It was stupid, boring,” says inmate Willem Boerema (not his real name), who claims to have taken part only because he likes Meffert [the young female researcher]. Then, contradicting himself, he adds that “if they say the study can help people then it’s good”.

Boerema, smart, articulate and multilingual, has a PCL-R rating of 35 and a big problem with the term ‘psychopath’. He views it as a fashionable label abused by the judicial system to keep people like himself from being released. “The courts look at your PCL-R rating and add two years to your sentence, then another two years, and then another.”

When he entered the prison five years ago, Boerema says, ‘borderline personality’ was the fashionable term, and his designated pigeon-hole. “The psychopathy label is more damaging though it prompts everyone to see you as a potential serial killer, which I could never be.” (Note, in reporting this article it was agreed that inmates’ crimes would be neither asked about nor reported on.) But Boerema also wears the score as a badge of honour: “I think my high psychopath score is a talent, not a sickness I can make good strong decisions, and it’s good to have some distance with people.”

I’m reminded of Freud’s comments on the following “piece of sophistry”:
A. borrowed a copper kettle from B. and after he had returned it was sued by B. because the kettle now had a big hole in it which made it unusable. His defence was: “First, I never borrowed a kettle from B. at all; secondly, the kettle had a hole in it already when I got it from him; and thirdly, I gave him back the kettle undamaged”….We might…say: “A. has put an ‘and’ where only “either-or” is possible.”

‘Boerema’s litany is classic. It’s ‘nonsense’, ‘stupid’, ‘boring’. I’m going along because I like the doctor, I want to help people. It’s ‘fashionable’, ‘damaging’, labeling, used as an excuse to keep him in prison. It’s a badge of honour, a talent. It’s not a sickness… In short, there is no such thing as psychopathy, but to the extent that it’s true, it’s a good thing.

Just two other uses to which the diagnosis might be put are: as a threat, and to elicit pity.

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There’s never anything wrong with the psychopath. This is perhaps the main reason why therapy doesn’t work with them – they have no motivation to change. But that’s a topic for another day!