How to tell if you share your life with a psychopath
We think of psychopaths as killers; aliens who live outside society. But you could have one for a colleague, friend or spouse
Published 06/05/2014 | 02:30
There are a few things we take for granted in social interactions with people. We presume that we see the world in roughly the same way, that we all know certain basic facts, that words mean the same things to you as they do to me. And we assume that we have pretty similar ideas of right and wrong.
But for a small – but not that small – subset of the population, things are very different. These people lack remorse and empathy and feel emotion only shallowly. In extreme cases, they might not care whether you live or die. These people are psychopaths. Some of them are violent criminals, even murderers. But by no means all.
Professor Robert Hare is a criminal psychologist, and the creator of the PCL-R, a psychological assessment used to determine whether someone is a psychopath. For decades, he has studied people with psychopathy and worked with them, in prisons and elsewhere. "It stuns me, as much as it did when I started 40 years ago, that it is possible to have people who are so emotionally disconnected that they can function as if other people are objects to be manipulated and destroyed without any concern," he says.
Our understanding of the brain is still in its infancy, and it's not so many decades since psychological disorders were seen as character failings. Slowly, we are learning to think of mental illnesses as illnesses like kidney disease or liver failure, and developmental disorders, such as autism, in a similar way. Psychopathy challenges this view.
"A high-scoring psychopath views the world in a very different way," says Hare. "It's like colour-blind people trying to understand the colour red, but in this case 'red' is other people's emotions."
At heart, Hare's test is simple: a list of 20 criteria, each given a score of 0 (if it doesn't apply to the person), 1 (if it partially applies) or 2 (if it fully applies). The list includes grandiose sense of self-worth, pathological lying, cunning/manipulative, lack of remorse, emotional shallowness, callousness and lack of empathy, lack of behavioural control, behavioural problems in early life and juvenile delinquency. A prototypical psychopath would score 40. A score of 30 or more qualifies for a diagnosis of psychopathy.
We think of psychopaths as killers, criminals, outside society. People such as Joanna Dennehy, a 31-year-old British woman who killed three men in 2013 and who the year before had been diagnosed with a psychopathic personality disorder, or Ted Bundy, the American serial killer who is believed to have murdered at least 30 people and who said of himself: "I'm the most cold-blooded son of a bitch you'll ever meet. I just liked to kill."
But many psychopathic traits aren't necessarily disadvantages – and might, in certain circumstances, be an advantage.
For their co-authored book, Snakes in Suits: When Psychopaths Go To Work, Hare and another researcher, Paul Babiak, looked at 203 corporate professionals and found about 4pc scored sufficiently highly on the PCL-R to be evaluated for psychopathy. Hare says that this wasn't a proper random sample (claims that "10pc of financial executives" are psychopaths are false), but it's easy to see how a lack of scruples and indifference to other people's suffering could be beneficial if you want to get ahead in business.
"There are two kinds of empathy," says James Fallon, a neuroscientist at the University of California and author of The Psychopath Inside: A Neuroscientist's Personal Journey into the Dark Side of the Brain. "Cognitive empathy is the ability to know what other people are feeling, and emotional empathy is the kind where you feel what they're feeling."
Autistic people can be very empathetic – they feel other people's pain – but are less able to recognise the cues we read easily, the smiles and frowns that tell us what someone is thinking. Psychopaths are often the opposite: they know what you're feeling, but don't feel it themselves. "This all gives certain psychopaths a great advantage, because they can understand what you're thinking, it's just that they don't care, so they can use you against yourself."
Prof Robert Hare recalls a meeting with one offender. Asked if he had any regrets about stabbing a robbery victim, the man replied: "Get real! He spends a few months in hospital and I rot here. If I wanted to kill him, I would have slit his throat. That's the kind of guy I am; I gave him a break."
But the issue of medical treatment for psychopaths is certainly a complicated one. "Psychopathy is probably the most pleasant feeling of all the mental disorders," says journalist Jon Ronson, whose book, The Psychopath Test, explored the concept of psychopathy and the mental health industry in general. "All of the things that keep you good, morally good, are painful things: guilt, remorse, empathy."
James Fallon agrees: "Psychopaths can work very quickly, and can have an apparent IQ higher than it really is, because they're not inhibited by moral concerns."
So psychopaths often welcome their condition, and 'treating' them becomes complicated. "How many psychopaths go to a psychiatrist for mental distress, unless they're in prison? It doesn't happen," says Hare. The ones in prison, of course, are often required to go to "talk therapy, empathy training, or talk to the family of the victims" – but since psychopaths don't have any empathy, it doesn't work. "What you want to do is say, 'Look, it's in your own self-interest to change your behaviour, otherwise you'll stay in prison."
It seems this message has been accepted by the UK Department of Justice: in its guidelines for working with personality-disordered inmates, it advises that while "highly psychopathic individuals" are likely to be "highly treatment resistant", the "interventions most likely to be effective are those which focus on 'self-interest' – what the offender wants out of life – and work with them to develop the skills to get those things in a pro-social rather than anti-social way."
If someone's brain lacks the moral niceties the rest of us take for granted, they obviously can't do anything about that, any more than a colour-blind person can start seeing colour. So where does this leave the concept of moral responsibility?
"The legal system traditionally asserts that all people standing in front of the judge's bench are equal. That's demonstrably false," says neuroscientist David Eagleman, author of Incognito: The Secret Lives of the Brain. He suggests that instead of thinking in terms of blameworthiness, the law should deal with the likelihood that someone will reoffend, and issue sentences accordingly, with rehabilitation for those likely to benefit and long sentences for those likely to be long-term dangers. The PCL-R is already used as part of algorithms which categorise people in terms of their recidivism risk.
"Life insurance companies do exactly this sort of thing, in actuarial tables, where they ask: 'What age do we think he's going to die?' No one's pretending they know exactly when we're going to die.
"But they can make rough guesses which make for an enormously more efficient system," says Eagleman.
What this doesn't mean, he says, is a situation like the sci-fi film Minority Report, in which people who are likely to commit crimes are locked up before they actually do. "Here's why," he says. "It's because many people in the population have high levels of psychopathy – about 1pc.
But not all of them become criminals. In fact, many of them, because of their glibness and charm and willingness to ride roughshod over the people in their way, become quite successful. They become CEOs, professional athletes, soldiers. These people are revered for their courage and their straight talk and their willingness to crush obstacles in their way.
"Merely having psychopathy doesn't tell us that a person will go off and commit a crime," he says.
Indeed it is central to our justice system, that you can't pre-emptively punish someone. And that won't ever change, according to Eagleman.
'SNAKES IN SUITS: WHEN PSYCHOPATHS GO TO WORK' BY PROFESSOR ROBERT HARE AND PAUL BABIAK (€10.99)