Understanding The Psychopath: Separating Fact From Fiction

Mention the word psychopath and I think it's fair to say that most people think of serial killers both real and fictional. As with criminal profiling, this is a topic area within forensic psychology where it is often difficult to separate fact from fiction. The aim of this article, therefore, is to do just that.

In order to understand the true nature of psychopathy, first and foremost, you need to be aware that psychopathy is a personality disorder, the diagnosis of which is usually based on detailed interviews with both the individual being assessed and their family.

However, the concept of personality disorder is extremely controversial, so much so, there are those that argue that personality disorder is nothing more than a term used by the medical profession to describe people they don't like.

What's the problem?

With most mental health problems, psychological testing can be employed to provide clear criteria as a basis for a diagnosis, there are, however, no such tests for personality disorder per se, so any diagnosis is by definition unreliable and lacking in validity.

The situation in the UK is particularly confusing because although the 1983 Mental Health Act differentiates between 'psychopathic disorder' and 'mental illness, it classifies both under the broader term of 'mental disorder.' At best, personality disorder sits uncomfortably within the traditional medical model of psychiatric classification, and more often than not resides outside it.

The most obvious consequence of this is that no medical treatment for underlying personality disturbance exists. This effectively means that personality disordered offenders cannot be accommodated within an appropriate health or penal/correctional setting.

A main aim of discussing personality disorder was to make it very clear from the start that the the psychopath is not mentally ill in the traditional sense of the word.

A common, yet understandable mistake is to assume that the terms psychopathy and psychotic are interrelated, they are not.

A psychotic individual is essentially out of touch with reality, she or he is likely to be delusional and experience hallucinations, and is, therefore, behaviourally speaking, completely unaware of what they are doing and why they are doing it.

Psychopathic behaviour on the other hand is rational, it represents an informed choice, a premeditated strategy to act in way that serves as an effective means to an end. As Robert Hare states (1993) in his seminal book, without conscience

'Psychopaths are social predators who charm, manipulate, and ruthlessly plow their way through life, leaving a broad trail of broken hearts, shattered expectations, and empty wallets. Completely lacking in conscience and in feelings for others, they selfishly take what they want and do as they please, violating social norms and expectations without the slightest sense of guilt or regret'.

Because of the possible confusion with the term psychotic, some writers prefer to employ the term sociopath, although like profiling, the preferred label more likely reflects the theoretical preference of the author.
For instance, Hare is explicit in his use of the term because he feels that it encapsulates his belief that the condition is a result of psychological, biological and genetic factors.

Psychopathy Checklist

I mentioned earlier that there isn't a rigorously tested and valid measure of personality disorder, however, a psychological test for psychopathy does exist, developed by Hare, it has become the standard instrument of choice for researchers and clinicians in the field.

The checklist examines key characteristics on a number of levels, for instance on an emotional/interpersonal level, the psychopath will reveal himself as glib & superficial, egocentric & grandiose, lacking in remorse, guilt and empathy, will be deceitful and manipulative and have shallow emotions

What Hare's research tells us more than anything is that the popular notion of the obviously insane serial killing psychopath has disguised the fact that most psychopaths actually operate within (or at least on the fringes) of the law, exist in large numbers and pervade every facet of society.