Quote: Hardened

“Young bodies are like tender plants, which grow and become hardened to whatever shape you've trained them.”

― Desiderius Erasmus

What exactly is psychopathy?

A reader sent this interesting article from one of our favorite researchers, Jennifer Skeem, whose previous attack on the PCL-R caused Robert Hare to take her to court and delay the publication before it was eventually released. The article is sort of an interesting primer on psychopathy and summary of the most recent research. She has her own ideas about the correct delineation of psychopathy that seems reasonable. First she discusses why there are so many ideas about what exactly sociopathy is:

As we will discuss, many of the controversies surrounding psychopathy stem from fundamental disagreements about its basic definition, or operationalization. The scope of phenomena encompassed by the term psychopathy has varied dramatically over time, from virtually all forms of mental disorder (psychopathy as “diseased mind”) to a distinctive disorder characterized by lack of anxiety; guiltlessness; charm; superficial social adeptness; dishonesty; and reckless, uninhibited behavior (Blackburn, 1998). Even contemporary conceptualizations of psychopathy contain puzzling contradictions. Psychopaths are often described as hostile, aggressive, and at times revenge driven (N. S. Gray, MacCulloch, Smith, Morris, & Snowden, 2003), yet they are also characterized as experiencing only superficial emotions (Karpman, 1961; McCord & McCord, 1964). They are impulsive and reckless, yet apparently capable of elaborate scheming and masterful manipulation (Hare, 1993). They can rise to high levels of achievement or status in society, attaining success in business and public life, yet present as criminals whose behavior is so poorly thought out and lacking in regard even for self-interest that they occupy bottom rungs of the social ladder

Given these contrasting depictions, it is scant wonder that some experts have concluded that the concept of psychopathy, as commonly understood, is disturbingly problematic: a “mythical entity” and “a moral judgment masquerading as a clinical diagnosis” (Blackburn, 1988, p. 511), “almost synonymous with ‘bad’” (Gunn, 1998, p. 34), “used by the media [to convey] an impression of danger, and implacable evil” (Lykken, 2006, p. 11). In the words of William and Joan McCord (McCord & McCord, 1964), two influential figures in the historic literature on psychopathy, “the proliferation of definitions, the tendency to expand the concept to include all deviant behavior, the discrepancies in judgment between different observers——these pitfalls in the history of the concept—— are enough to make a systematic diagnostician weep” (p. 56).

She then (optimistically) asserts that all is not lost, that sociopathy is a thing and we can figure out what that thing is through careful parsing of the literature and empirical evidence. First she dispels some myths:

• Psychopathy is synonymous with violence: "However, psychopathy can and does occur in the absence of official criminal convictions, and many psychopathic individuals have no histories of violence."
• Psychopathy is synonymous with psychosis: "In contrast with psychotic patients, psychopathic individuals are generally rational, free of delusions, and well oriented to their surroundings"
• Psychopathy is synonymous with antisocial personality disorder (ASPD): "The difference arises largely because measures of psychopathy include personality traits inferable from behavior, whereas measures of ASPD more exclusively emphasize antisocial, criminal, and (to a lesser extent) violent behavior."
• Psychopathic individuals are born, not made: "Contemporary understanding of the pervasive interplay of genetic and environmental influences in determining behavioral outcomes of various kinds argues against the likelihood that any psychiatric condition, including psychopathy, is entirely 'born' or 'made.'"
• Psychopathy is inalterable: "some recent empirical work has emerged to suggest that personality traits in general, and psychopathic traits more specifically, undergo change across major developmental transitions"

The article is quite long. I will probably keep going back to it over the next month or so and perhaps sharing things that I learn here.

Nurture trumping nature

I have posted before about James Fallon, neuroscientist, University of California, Irvine, professor, psychopath expert, and successful psychopath (?) before.  I thought this video was worth posting as well because it targets more the personal experience of what his family thinks about who he is and his childhood was instrumental in Jim not developing into a killer, despite his brain and genetic predispositions.




6:55: His mother tells him about how Lizzie Borden is a cousin of his.  On one line of his family there were at least 16 murderers.

7:54: He decides to check the brain scans and DNA of his family members for the brain signatures and genes linked to psychopathy.  He discovers everyone is normal except for him, who has the brain scan signature of a killer and all of the genetic markers predisposing to impulsivity, violence, etc.

10:05: Reaction from his family "I knew there was always something off.  It makes more sense now."  "Everything that you would want in a serial killer he has in a fundamental way."  "It was surprising but it wasn't surprising."  "He's always had a standoffish part to him."

11:00: Jim is honest with himself "I have characteristics or traits, some of which are . . . psychopathic." he gives the example of how he could blow off an aunt's funeral.  "I know something's wrong, but I still don't care."

11:40: Why wasn't he a killer?  "Whether genes are triggered or not will depend on what happens in your childhood."

12:28: "It turns out that I had a unbelievably wonderful childhood."

I think this is an interesting and accurate portrayal of what a high functioning psychopath might look like.  I think people expect to see very obvious differences, but frequently they're not obvious or they're not really visible.  It's like this response from Jennifer Kahn, author of that NY Times Magazine article on psychopathic children, when asked about whether the child's behavior was more or less extreme than she expected:

I think I expected Michael to be more immediately extreme. When I arrived, he was on his good behavior, but he did get extreme later in the night. Something that Waschbusch said he struggles with is that it is hard to define what is prepsychopathic behavior and what is behavior caused by a different kind of problem — it does tend to cross different diagnoses. It wasn’t the screaming or fits or slamming the toilet seat that struck me; it was the calculated coldness and the flip between emotional states. But I had expected it to be more obvious. When I entered the house, of course, I was thinking of adult psychopaths who have led criminal lives for decades, which is normally how they come to our attention. I was maybe expecting a child version of that, but of course that’s kind of ridiculous. Even among adult psychopaths, that would be a small minority.