Saturday, October 21, 2017

Some Surprising Reasons Why Identifying Psychopaths is Harder Than You May Think

  by Nomad

Confessions of a Psychopath-Spotter

I recently found this extremely interesting and amusing TED talk by Jon Ronson. Even though you've probably never heard of him, Ronson's career covers a lot of ground: a journalist, author, documentary filmmaker, screenwriter, and radio presenter. And one other thing,  he is also a certified psychopath-spotter. He's taken the course and everything.

His TED lecture begins with Ronson stumbling across a DSM manual, the comprehensive manual of mental disorders. If you don't know, the DSM Manual is produced by the American Psychiatric Association and serves as the official authority on mental health diagnoses (and related insurance claims).

The manual weighs in at a hefty 886 pages long and lists currently 374 mental disorders. Some of them have only been recently recognized such as Internet gaming disorder,  Social (Pragmatic) Communication Disorder, Premenstrual Dysphoric Disorder, and Excoriation (Skin-Picking) Disorder.

Being a bit hypersensitive and British, Ronson was not surprised to find that he himself qualified for 12 distinct illnesses, such as generalized anxiety disorder, dream anxiety disorder, and parent-child relational problems.

For anybody looking to question their sanity, the manual is a veritable treasure trove of possibilities. It has also led to a bit of doubt about the veracity of the way we identify mental disorders. Leo McKinstry, a British journalist  and medical non-professional recently wrote:
A key element of today’s approach is to medicalize the human condition by remorselessly expanding the definition of mental illness. All sorts of normal feelings, such as sadness, anxiety, grief and fear, are now held to be worrying symptoms of a breakdown, requiring intervention through talking cures or psychotropic drugs.
While Ronson didn't deny the accuracy of the diagnosis in his own case, he was also, like McKinstry, a tad skeptical. The indications of mental illness seemed to be all-inclusive and could, in the wrong hands, be used to rule anybody mad as a hatter. Ronson the curious, asked:
  • If there are so many disorders out there, how can qualified physicians define what normal mental behavior is? 
  • Does, asked Ronson, the psychiatry profession have a kind of strange desire to label what's essentially normal human behavior as a mental disorder?
  • Is it actually possible for doctors to distinguish the normal and the sane from the dangerous and the unhinged? 
Those are particularly pertinent and serious questions in our times when a man who, by all appearances, is sane as anybody but who can extinguish over 50 innocent lives from his hotel window like the Las Vegas shooter, Stephen Paddock.
All without blinking an eye.

Psychopaths Among Us

How could such a monster go unnoticed? Logically, somebody who could do such an outrageous and antisocial act- an understatement, to be sure- should stand out in any social environment like a porcupine at a nudist's colony.

The truth is quite different. Even though the disorder of psychopathy is an object of popular fascination, it's not easy to determine who is and who is not one.
As an article in Psychology Today points out:
The psychopath can appear normal, even charming. Underneath, he lacks conscience and empathy, making him manipulative, volatile and often (but by no means always) criminal.
It is, like so many other illnesses found in the DSM, a spectrum disorder and can be diagnosed only using the 20-item Hare Psychopathy Checklist. Anyone fitting enough of these criteria counts as a psychopath or sociopath.
Incidentally, in case you are wondering if there's no difference between the two, psychopaths or sociopaths, you can find the answer here. To summarize, the term “psychopath” was first used by doctors in the 19th century but it was confused with moral and ethical labels which tended to cloud accuracy.
Psychopathy is usually defined by non-professionals like this:
a mental disorder in which an individual manifests amoral and antisocial behavior, lack of ability to love or establish meaningful personal relationships, extreme egocentricity, failure to learn from experience, etc.
It was used in the medical sense that we now do around the early 1900s.
Then, around 1930s, the term “sociopath” became standard issue to emphasize the damage this type of individual does to society (rather than unfortunate friends, family, and neighbors.) 
Then the tide of terminology shifted again.
Currently researchers have returned to using the term “psychopath.” Some of them use that term to refer to a more serious disorder, linked to genetic traits, producing more dangerous individuals, while continuing to use “sociopath” to refer to less dangerous people who are seen more as products of their environment, including their upbringing.
Even armed with a checklist, Ronson soon found it was a daunting task to be an effective psychopath-spotter.

The Man Who Fooled the Doctors

To delve into this subject, Ronson's first stop was a trip to Broadmoor, a high-security psychiatric hospital in Berkshire, England. This facility is where some of Britain's most infamous prisoners call home. Names include paranoid schizophrenic Robert Clive Napper, a convicted British murderer and rapist, the Stockwell Strangler, Kenneth Erskine and the infamous English serial killer who was dubbed The Yorkshire Ripper, Peter William Sutcliffe.
Most of the patients suffer from severe mental illnesses and many also have personality disorders.

There he met Tony, a clever chap who got himself in a right pickle. In order to escape punishment for a beating, Tony decided to outsmart the system and pretend to be a psychopath. With a bit of mimicry and some reading up, he convinced doctors he was a dangerous psychopath.

However, when he realized that Broadmoor was not his cup of tea, the very same doctors refused to believe him. In fact- and here's the interesting part- all of his denials and attempts to appear sane became part of their diagnosis. It was a classic Catch-22.
Tony realized a hard-won truth.
it's a lot harder to convince people you're sane than it is to convince them you're crazy.
In a weird paradox, faking madness, Ronson points out, is exactly the kind of cunning and manipulative act of a psychopath. "It's on the checklist: cunning, manipulative."
Naturally, Tony tended to keep to himself and this too was taken as a fulfillment of expectations.
So, only in Broadmoor would not wanting to hang out with serial killers be a sign of madness.
Had Tony gone to prison as he normally would have, he would have served 4 years. However, he was eventually released from Broadmoor 14 years later when doctors were convinced he had "recovered."

Here are some not-too-comforting statistics worth noting before you begin chasing down the clinically insane. If the assessment tools are correct, psychopaths are literally all over the place. Ronson explained:
One in a hundred regular people is a psychopath. So there's 1,500 people in his room. Fifteen of you are psychopaths.
Could this be true? Ronson wasn't exactly sure. Yet, there was another statistic that must be taken into account as well.
Although that figure rises to four percent of CEOs and business leaders, so I think there's a very good chance there's about 30 or 40 psychopaths in this room. It could be carnage by the end of the night.
And that brings us to a new avenue to explore: how society has come to respect and admire psychopathic behavior.

Rewards for Psychopathic Ruthlessness

The idea that the psychopath is a standard and appreciated fixture of the business world is supported by an interview he had with a hedge fund of the Mitt Romney variety, Al Dunlap.
Unlike Romney, Wikipedia describes Dunlap as "a disgraced former corporate executive" "a turnaround specialist and professional downsizer." However, it would be discovered that all of his turnarounds were, in reality, elaborate frauds. 

Also known as "Chainsaw," Dunlap was selected for Time's Top Ten Worst Bosses list in 2010. At his peak, Dunlap wrote a best-selling manifesto titled Mean Business.In the book, he writes:
You’re not in business to be liked… We’re here to succeed.
Dunlap's behavior as a CEO earned him a dubious reputation that eventually led to his downfall.
After the investors' meeting, at which 200 Wall Street honchos were in attendance, Dunlap accosted one of his skeptics, placing his hand over an employee's mouth and, according to a report by the magazine then known as Businessweek, yelled into his ear, "You son of a bitch. If you want to come after me, I'll come after you twice as hard."
In his interview with Dunlap, Ronson saw all the signs he had been trained to look out for. There were images of predatory animals all over Dunlap's home and a sculpture of four sharks encircling the planet. “Sharks,” he explained to Ronson. “Their spirit will enable you to succeed.” Mindless, instinctual gobblers of flesh?
Dutifully, Ronson went through the checklist for the diagnosis of clinical psychopathy. He immediately discovered a problem.

For every positive psychopathic trait Ronson detected, Dunlap could mount a perfectly plausible, socially-acceptable excuse taken from any "make it to the top" type of bestseller.

So what really is the difference between possessing a psychopath's "grandiose sense of self-worth" and having a successful CEO's unshakeable self-confidence in one's abilities? Where is the distinction between superb business leadership skills and manipulative psychopathic behavior? Does it really all just boil down to semantics and context?

Take this exchange between Ronson and Dunlap.
And I said, "Shallow affect, an inability to experience a range of emotions." He said, "Who wants to be weighed down by some nonsense emotions?"
Obviously, there was a bias problem to contend with.

Psychopath-spotting Ronson (even with the help of an official assessment tool) realized might be making the same misjudgments of the Broadmoor doctors. Ronson was actually adapting the profile to match the patient in order to justify the psychopathic verdict.
I was desperate to define him by his maddest edges.
Did Dunlop truly fit a psycho profile? or did he actually prove its hidden inadequacies of the way we diagnose mental illness? He had to go back to his instructor to understand whether or not his own prejudices were attempting to make every overzealous CEO into a socially-toxic psychopath.

The Capitalist Normalization of Psychopathy

Clearly, when it came to the business world, the checklist clearly had its shortcomings. What could account for that, Ronson wondered. The author of that checklist, psychologist Robert Hare, had his theories. 
Hare is a researcher in the field of criminal psychology. He told Ronson that the reason why is there is such a connection between the business world and the world of the psychopath can be easily explained.
Capitalism, he stated, at its most ruthless rewards psychopathic behavior -- the lack of empathy, the glibness, cunning, manipulative.

In fact, Ronson notes, capitalism, at its unregulated extreme, is a physical manifestation of psychopathy.
"It's like a form of psychopathy that's come down to affect us all."
Strong business leaders aren't known for their overwhelming empathy (there are, of course, some noteworthy exceptions) or for making deep and meaningful emotional connections with people they work with.
Concern for the feelings of others is generally considered something of a liability to a hard-nosed businessman. Those kinds of emotions might make dismissals and other difficult but necessary decisions much more stressful.

If every hedge fund manager became tearful and guilt-stricken whenever manufacturing plants in Indiana or Wisconsin had to be closed, nothing would ever get done in this country. The same could be said for politicians who must decide between cutting taxes for the super-wealthy and slashing federal assistance for school lunch programs.

As an essay in Brain Theory: Essays in Critical Neurophilosophy points out:
Psychopaths, and to a degree, sociopaths, show a lack of emotion, especially the social emotions, such as shame, guilt, and embarrassment.
That's not to say that every boss or politician is a psychopath even though it sometimes seems the case. There is a distinction.

A CEO or a member of Congress without psychopathic tendencies would probably have no hesitation to fire an employee or slash a program that millions depend on. Yet, he or she could retain a sense of empathy. In contrast, one with psychopathic tendencies would feel nothing or perhaps take a particular satisfaction at the opportunity to fire a member of staff.
Whether it meant foreclosing on the homes of tens of thousands of seniors or booting a disabled person from your Congressional office, the true psychopath would feel nothing.

In that light, a TV show like "The Apprentice" -in which the cut-throat behavior of the business world is exaggerated for the sake of entertainment- becomes much more like a school for psychopaths and, still worse, a social normalization of psychopathic behavior.

"I am not here to make friends. I am here to win" is the phrase almost every competitive reality TV show uses. As if winning at any cost is an appropriate excuse for all psychopathic acts.This is, the producers of the show imply, is what it takes to win as a CEO.

In fact, there's a problem with rationale.
According to an intriguing study recently published in the journal Personality and Social Psychology Bulletin, published by the Society for Personality and Social Psychology, hedge fund managers higher in “dark triad” personality traits – psychopathy, narcissism, and Machiavellianism - actually perform more poorly than their peers. Managers with psychopathic traits performed slightly below average and those with narcissistic Traits tended to take more investment risks to earn the same amount of money as less narcissistic peers. The authors of the study concluded:
“When choosing our leaders in organizations and in politics, we should keep in mind that psychopathic traits—like ruthlessness and callousness—don’t produce the successful outcomes that we might expect them to.”
The idea that being ruthless and conniving cut-throat offers anybody an advantage may be a fallacy.

Checking the Checklist

Back to the checklist.
In addition to a lack of social emotions and empathy, there are other items on the psychopathy assessment checklist worth noting:
  • Do you have a constant need for stimulation? 
  • Do you have lack of remorse or guilt?
  • Do you have shallow affect (superficial emotional responsiveness)?
  • Do you have poor behavioral controls?
  • Are you sexually promiscuous?
  • Are you overly impulsive?
  • Do you fail to accept responsibility for own actions?
  • Do you display criminal versatility? That's an attitude that the laws do not apply to you. 
In 1964, social psychologist Erich Fromm coined the term "malignant narcissism" to describe a specific form of "severe mental sickness" representing "the quintessence of evil." According to Fromm, this condition represented "the most severe pathology and the root of the most vicious destructiveness and inhumanity."
Experts often use the terms malignant narcissism and psychopathy interchangeably because there's no clinical difference between them and both can be measured and referenced using the Hare Checklist. 

Here's a checklist specifically diagnosing this particular aspect of psychopathic behavior with Trump as the patient.
Two points to keep in mind, the checklist was probably not completed by a professional and it is based only Trump's publicly-exhibited behavior.

Speaking to a journalist from SalonDr. Lance Dodes, an assistant clinical professor of psychiatry at Harvard Medical School (retired) and a training and supervising analyst emeritus at the Boston Psychoanalytic Society and Institute, gave his own diagnosis based on his own observations.

The president of the United States has "a fundamental, deep psychological defect."Trump's case of narcissism is particularly severe, says Dodes, and he exhibits an "inability to empathize with others and his lack of genuine loyalty to anyone."
He is extremely paranoid, and it edges into delusion. He does not really know what the truth is, at least at those moments. All these descriptive labels are true. If you put them all together, you have got a picture of Donald Trump.
In February, Dodes signed an open letter to The New York Times which warn the public about the dangers posed by Donald Trump's mental health. He is also a contributing writer for the new book "The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President."
Not every professional agrees with this diagnosis. For example, Dr. Allen Frances a well-known psychiatrist who is an authority personality disorders does not think Trump is necessarily a threat to the nation.  
Frances points out:
Narcissism is very common in political leaders, celebrities, doctors, lawyers, and professors, but it’s not a disqualifying criterion for governing. Even if people have mental disorders, that doesn’t mean they can’t be great leaders.
All these conflicting opinions on a life-or-death matter brings us to a sad truth. 
We are never going to be able to identify and keep dangerous psychopaths from occupying hotel rooms and inflicting mass murder on innocent victims when can't even keep them from occupying the White House.

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Here's Jon Ronson's entire TED speech from 2012. Long but entertaining. For a transcript of the speech, click here.