What is a psychopath, anyway? (“Psycho Killer, qu'est-ce que c'est?") Robert Hare, who started out as a psychologist at a maximum security prison in Vancouver, has spent a lifetime studying them. They are not, he says, just the murderous, chainsaw-wielding, Hannibal Lecter characters we imagine. There are plenty of non-criminal psychopaths, too, he says—driven, high-functioning, succeed-at-any-cost characters who live among us, at loose in the wild. They can be found in all walks of life. They love power. They love to win. In his 1993 book Without Conscience: The Disturbing World of the Psychopaths Among Us, Hare estimated there were at least 2 million psychopaths in North America, with 100,000 in New York City alone—psychopaths like the bright lights, apparently.
And the bright lights, seemingly, like them. Society applauds the non-axe-wielding kind of psychopath. They are celebrated. They are idolized. They stalk the corridors of power, finance, culture. They are our sporting heroes (is Lance Armstrong a psychopath? Oscar Pistorius?) The higher you climb in any field, the more of them you will encounter. Poor psychopaths go to jail, as they say, while rich ones go to business school.
There’s a theory that psychopaths have a profound effect on society: Their pathologically single-minded pursuit of success makes them catalysts of capitalism—the world is run by the greed-is-good Gordon Gecko types who write the rules in their favour and happily trample over anyone that gets in their way. Jon Ronson, author of The Psychopath Test: A Journey Through the Madness Industry, writes: “Capitalism, at its most ruthless, is a physical manifestation of psychopathy. Theirs is the brain anomaly that shapes our world.”
So what exactly is their brain anomaly? What makes a psychopath? Hare has identified 20 characteristics of psychopaths that are used in his diagnostic test, the Psychopathy Checklist-Revised (PCL-R), such as: Glibness/superficial charm; Grandiose sense of self-worth; Pathological lying; Cunning/manipulative; Lack of remorse or guilt; Shallow emotions; Callousness/lack of empathy; Failure to accept responsibility for own actions; Need for stimulation/proneness to boredom; Impulsivity; Early behaviour problems; Promiscuous sexual behaviour. (Take this quiz if you want to find out your level of psychopathy.) Psychopaths are generally considered to have been born that way. They are the bad seeds of our species. The psychopath’s less-charming counterpart, the “sociopath,” by contrast, is someone whose unpleasant habits supposedly derive more from bad nurture instead of bad nature.
On balance, does the word “psychopath” really mean anything? It’s a convenient short-hand for a certain kind of cold-blooded ruthlessness; a cheap bit of lingo for slasher movie publicists. It’s a construct that might prove useful in criminal/forensic settings. But in the psychotherapeutic world it has questionable value. Like so many psychological diagnoses, it’s a vague label dressed up as a discrete, objectively-measurable, uniform condition. And it’s of course highly pejorative and demonising, offering no hope of change and restitution. Psychopathy isn’t even a disorder in the industry standard reference book, the Diagnostic and Statistical Manual of Mental Disorders—psychopathy only gets a brief mention in the description of “antisocial personality disorder.”
ASP is defined as “a pervasive pattern of disregard for and violation of the rights of others” and includes criminal activity among its diagnostic indicators (eg. “Failure to conform to social norms with respect to lawful behaviors"). This raises the question of whether people diagnosed with ASP should be treated as ill, or criminal—are they mad, or simply bad? As Lorna Smith-Benjamin points out, “It would be circular to define a mental disorder in terms of criminal behavior, and then to excuse a person from criminal behavior because he or she has a mental disorder!" Regardless, treatment is very difficult because of what Smith-Benjamin calls “the near-impossibility of getting collaboration from the ASP, who is not at all interested in changing his or her interactive patterns."
But the term "psychopath" is frequently used far beyond the tight, criminal definitions of ASP. There’s a sense that when you start looking for a condition, you invariably find it—to someone with a hammer, everything looks like a nail, as the saying goes. Ronson writes: “There is a terrible seductive danger in spotting psychopaths everywhere. In fact becoming a psychopath spotter turns you a little psychopathic. You start to dehumanize people, define them by their maddest edges, wedge people into the box marked psychopath. Almost every journalist I meet asks me, Is Donald Trump a psychopath? . . . How easy it is to marginalize (and lock up) anyone who doesn't agree with us.” (This summer I interviewed Trump, the billionaire property tycoon, for the American magazine Golf Digest. The Q&A is in the November issue and available online. You can read it here and make up your own mind about his psychological state.)
People do like to pigeon-hole other people. And some people like to be pigeon-holed. Some take great comfort in a diagnosis and they wear the label like a badge of honour. It de-mystifies their symptoms, allows them to get the help and support they need and can put them in touch with other sufferers. That’s all fine. The danger is that the individual often gets overlooked—they are no longer a human being but a “schizophrenic,” “alcoholic,” “autistic,” “disabled,” “bipolar,” “psychotic.” Assumptions are made, prescriptions written, and nobody actually bothers to listen to the person’s own, unique subjective experience or thoughts or ideas. People who become patients sometimes miss the person they were pre-diagnosis, and the way they used to be treated, back when they were considered “normal.” When they stop taking their medications, it can be a doomed, subconscious attempt to return to that old self.
Labels tend to stick. They become self-fulfilling prophecies. They limit who we are and who we can become. There are many, many other, less pathological labels that can adhere to us from a very early age. “Bad at maths” or “sporty” or “the quiet one” or “the difficult one” or the one who was “never any trouble.” One of the goals of therapy can be to take away these old, worn out labels. Sometimes the glue is so strong that they can’t be removed. Sometimes they can be, but it’s painful. And sometimes the client discovers, to their great surprise, that there is nothing at all holding the label to them, and it instantly vanishes into thin air.