Saturday, November 15, 2008

On Moral Derangement: The Psychopath Carries Disaster Lightly In Each Hand...

"Psychopaths are as old as Cain, and they are believed to exist in all cultures, although they are more prevalent in individualistic societies in the West. The Yupik Eskimos use the term "kunlangeta" to describe a man who repeatedly lies, cheats, steals, and takes sexual advantage of women, according to a 1976 study by Jane M. Murphy, an anthropologist then at Harvard University. She asked an Eskimo what the group would typically do with a kunlangeta, and he replied, “Somebody would have pushed him off the ice when nobody else was looking.”

The condition was first described clinically in 1801, by the French surgeon Philippe Pinel. He called it “mania without delirium.” In the early nineteenth century, the American surgeon Benjamin Rush wrote about a type of “moral derangement” in which the sufferer was neither delusional nor psychotic but nevertheless engaged in profoundly antisocial behavior, including horrifying acts of violence. Rush noted that the condition appeared early in life.

The term “moral insanity” became popular in the mid-nineteenth century, and was widely used in the U.S. and in England to describe incorrigible criminals. The word “psychopath” (literally, “suffering soul”) was coined in Germany in the eighteen-eighties. By the nineteen-twenties, “constitutional psychopathic inferiority” had become the catchall phrase psychiatrists used for a general mixture of violent and antisocial characteristics found in irredeemable criminals, who appeared to lack a conscience.

In the late nineteen-thirties, an American psychiatrist named Hervey Cleckley began collecting data on a certain kind of patient he encountered in the course of his work in a psychiatric hospital in Augusta, Georgia. These people were from varied social and family backgrounds. Some were poor, but others were sons of Augusta’s most prosperous and respected families. Cleckley set about sharpening the vague construct of constitutional psychopathic inferiority, and distinguishing it from other forms of mental illness. He eventually isolated sixteen traits exhibited by patients he called “primary” psychopaths; these included:

Being charming and intelligent, unreliable, dishonest, irresponsible, self-centered, emotionally shallow, and lacking in empathy and insight.

“Beauty and ugliness, except in a very superficial sense, goodness, evil, love, horror, and humor have no actual meaning, no power to move him,” Cleckley wrote of the psychopath in his 1941 book, “The Mask of Sanity,” which became the foundation of the modern science. The psychopath talks “entertainingly and is “brilliant and charming,” but nonetheless “carries disaster lightly in each hand.” Cleckley emphasized his subjects’ deceptive, predatory nature, writing that the psychopath is capable of “concealing behind a perfect mimicry of normal emotion, fine intelligence, and social responsibility a grossly disabled and irresponsible personality.” This mimicry allows psychopaths to function, and even thrive, in normal society.

Indeed, as Cleckley also argued, the individualistic, winner-take-all aspect of American culture nurtures psychopathy.

The psychiatric profession wanted little to do with psychopathy, for several reasons. For one thing, it was thought to be incurable. Not only did the talking cure fail with psychopaths but several studies suggested that talk therapy made the condition worse, by enabling psychopaths to practice the art of manipulation. There were no valid instruments to measure the personality traits that were commonly associated with the condition; researchers could study only the psychopaths’ behavior, in most cases through their criminal records. Finally, the emphasis in the word “psychopath” on an internal sickness was at odds with liberal mid-century social thought, which tended to look for external causes of social deviancy; “sociopath,” coined in 1930 by the psychologist G. E. Partridge, became the preferred term. In 1958, the American Psychiatric Association used the term “sociopathic personality” to describe the disorder in its "Diagnostic and Statistical Manual of Mental Disorders." In the 1968 edition, the condition was renamed “general antisocial personality disorder.”

Cleckley’s book fell out of favor, and Cleckley described himself late in life as “a voice crying in the wilderness.” When he died, in 1984, he was remembered mostly for his popular study of multiple-personality disorder, written with Corbett Thigpen, “The Three Faces of Eve.”

One of Kiehl's postdocs, Karla Harenski recently interviewed a Western prison inmate who scored a 38.9. “He had killed his girlfriend because he thought she was cheating on him,” she told me. “He was so charming about telling it that I found it hard not to fall into laughing along in surprise, even when he was describing awful things.” Harenski, who is thirty, did not experience the involuntary skin-crawling sensation that, according to a survey conducted by the psychologists Reid and M. J. Meloy, one in three mental-health and criminal-justice professionals report feeling on interviewing a psychopath; in their paper on the subject, Meloy and Meloy speculate that this reaction may be an ancient intraspecies predator-response system. “I was just excited. I was saying to myself, ‘Wow. I found a real one."

The Hare Psychopathy Checklist:

Robert D. Hare, Ph.D., is considered one of the world's foremost experts in the area of psychopathy and he is the author of the popular book, "Without Conscience." Dr. Hare is a professor of psychology at the University of British Columbia, and has researched psychopathy for more than twenty years. The following is his well-known and implemented Hare Psychopathy Checklist. For each characteristic that is listed, the subject is given a score: 0 for "no," 1 for "somewhat," and 2 for "definitely does apply."

1. Glibness/superficial charm
2. Grandiose sense of self-worth
3. Need for stimulation/proneness to boredom
4. Pathological lying
5. Conning/manipulative
6. Lack of remorse or guilt
7. Shallow affect
8. Callous/lack of empathy
9. Parasitic lifestyle
10. Poor behavioural controls
11. Promiscuous sexual behaviour
12. Early behaviour problems
13. Lack of realistic, long-term plans
14. Impulsivity
15. Irresponsibility
16. Failure to accept responsibility for own actions
17. Many short-term relationships
18. Juvenile delinquency
19. Revocation of conditional release
20. Criminal versatility

Narcissism is also a characteristic.

Sound familiar anyone?

- John Seabrook, (Excerpt: “Suffering Souls,” The New Yorker, 11.10.08. Image: -Jean-Philippe Charbonnier, Paris Psychiatric Hospitals, 1954).


philip said...

Yes, I've worked for a real psychopath before. He was very annoying, eventually I realized I was being used when after working very hard weekends and late nights and it came to my review he gave me all bad scores. I was set up to be the fall guy for his problems he didn't want to take the blame for.

Sheilanagig said...

I cant resist the obvious conclusion that pyschopathy is the cultural norm for Americans, differing only in the amount of power they posess to express themselves.

It would be interesting to do an analysis of this trait vis a vis the victim mentality.

I offer you this url from a fantastic jazz musician, gilad atzmon on pre-traumatic stress disorder, who has put this theory to use where it belongs, in mideast politics.
Thanks your your insightful article.