De­spite what Hol­ly­wood sug­gests, psychopaths aren’t easy to recog­nise due to their habit of ac­ces­soris­ing with a blood-soaked axe and a ma­ni­a­cal leer. So how can you spot them, should you be wor­ried, and could you be work­ing along­side one right now?

Focus-Science and Technology - - CONTENTS - WORDS: DR NI­COLA DAVIES

Psy­chol­o­gist and writer Ni­cola re­veals why there are more psychopaths around than you think (and why that’s prob­a­bly okay).

Chillingly cool, col­lected, cun­ning and clever. Is this the per­fect de­scrip­tion of a psy­chopath? For most peo­ple, Hol­ly­wood movies and pop­u­lar cul­ture gen­er­ate such im­ages of psy­chopa­thy. Be it An­thony Hop­kins as Dr Hannibal Lecter in The Si­lence Of The Lambs or Psy­cho’s Nor­man Bates, such char­ac­ters dom­i­nate the pub­lic’s per­cep­tion of a psy­chopath. But how close is this pop­u­lar im­age to re­al­ity?

The term ‘psy­chopath’ orig­i­nated in the 1800s, from the Greek words ‘psykhe’ and ‘pathos’, which mean ‘sick mind’ or ‘suf­fer­ing soul’, re­spec­tively. How­ever, this can be mis­lead­ing.

“Psychopaths might be bet­ter con­cep­tu­alised as peo­ple who are dis­so­ci­ated,” says crim­i­nol­o­gist Robert Blakey. “In other words, peo­ple who are de­tached from their own emo­tions and the emo­tions of other peo­ple. Con­se­quently, they just don’t feel much. If they see a per­son in dis­tress, psychopaths don’t feel the dis­tress them­selves, so they have less emo­tional in­cen­tive not to harm peo­ple.”

Blakey be­lieves this dis­so­ci­a­tion can arise from in­her­it­ing an over-sensitive per­cep­tual sys­tem. “If you’re very sensitive to vis­i­ble signs of dis­tress and anger in other peo­ple, then see­ing those signs could be­come over­whelm­ing for highly sensitive chil­dren,” he says. “A deficit in one’s abil­ity to pre­dict other peo­ple’s be­hav­iour as a child can be a trau­matic ex­pe­ri­ence and, in re­sponse, the child’s brain may dis­so­ci­ate.” In other words, the em­pa­thy sys­tem shuts down to sur­vive the emo­tions of oth­ers. The irony here is that peo­ple born with an ex­ces­sive ca­pac­ity to em­pathise could be more likely to de­velop psy­cho­pathic traits due to los­ing their full ca­pac­ity for em­pa­thy in their ef­forts at self-preser­va­tion.

This has par­al­lels with a sim­i­lar the­ory about autism which, like psy­chopa­thy, is a disorder of so­cial cog­ni­tion. While autism is typ­i­cally con­sid­ered a deficit in cog­ni­tive em­pa­thy,


or per­spec­tive tak­ing, psy­chopa­thy is a deficit in emo­tional em­pa­thy. While the re­la­tion­ship be­tween autism and psy­chopa­thy has gained in­creas­ing in­ter­est due to the shared lack of em­pa­thy, re­search in­di­cates many dis­tinc­tions be­tween the two conditions. The most rel­e­vant dis­tinc­tion is that in­di­vid­u­als with autism are not amoral, un­like psychopaths.


One way to iden­tify a psy­chopath is to study pat­terns in their re­la­tion­ships. Psychopaths gen­er­ally can­not sus­tain long-term re­la­tion­ships, so short pe­ri­ods of in­ten­sity fol­lowed by de­tach­ment tend to de­fine their close in­ter­ac­tions. While in a re­la­tion­ship, their be­hav­iour is likely to be highly ma­nip­u­la­tive and self­ish, with their needs al­ways com­ing first.

Not all psychopaths are vi­o­lent crim­i­nals, but most present a threat to our wel­fare at some level – to one’s self-es­teem, peace of mind, sexual health or fi­nan­cial well­be­ing. There are many the­o­ries be­hind why psychopaths are the way they are. Some be­lieve it is na­ture, or ge­net­ics, that causes psy­chopa­thy. Oth­ers think it is re­lated to en­vi­ron­men­tal fac­tors. What­ever the cause, med­i­cally speak­ing peo­ple with psy­cho­pathic ten­den­cies demon­strate cer­tain traits.

Re­searchers from Har­vard Uni­ver­sity in­ves­ti­gat­ing de­ci­sion-mak­ing in psychopaths took mag­netic res­o­nance imag­ing (MRI) brain scans of 50 prison in­mates, with the aim of in­ves­ti­gat­ing the choices that psychopaths make. They found that peo­ple with signs of psy­chopa­thy had brains that were wired so that they over-val­ued im­me­di­ate or short-term re­wards. This de­sire for in­stant gratification over­shad­owed any con­cern about the con­se­quences of their ac­tions.

They also found that peo­ple who scored highly on the pa­ram­e­ters of psy­chopa­thy – as as­sessed by a de­layed gratification test, an es­ti­ma­tion model, and the Psy­chopa­thy Check­list (PCL-R) – showed greater ac­tiv­ity in the brain’s ven­tral stria­tum. This is a key part of the re­ward sys­tem. In an­other study of 164 chim­panzees car­ried out at the Uni­ver­sity of Ge­or­gia, re­searchers found that a neu­ropep­tide called va­so­pressin is as­so­ci­ated with the de­vel­op­ment of so­cioe­mo­tional be­hav­iours re­lated to psy­cho­pathic per­son­al­i­ties. This adds fur­ther sup­port to a ge­netic el­e­ment in the de­vel­op­ment of psy­cho­pathic traits.

En­vi­ron­men­tally, the im­pact of so­cial­i­sa­tion in a child’s early years is per­haps equally in­flu­en­tial in the

for­ma­tion of psy­cho­pathic be­hav­iour. And ac­cord­ing to Clau­dio Vieira, a clin­i­cal psy­chol­o­gist based at King’s Col­lege, Lon­don, many dif­fer­ent per­son­al­ity dis­or­ders – in­clud­ing psy­cho­pathic per­son­al­i­ties – may re­sult from a com­bi­na­tion of ge­netic el­e­ments that shape our per­son­al­i­ties, life ex­pe­ri­ences, and so­cioe­co­nomic cir­cum­stances.

Psy­cho­pathic char­ac­ter­is­tics also vary by cul­ture. A US and Nether­lands study com­pris­ing over 7,000 crim­i­nals ex­hibit­ing psy­cho­pathic traits re­vealed that US-based of­fend­ers tended to pre­dom­i­nantly dis­play the psy­cho­pathic trait of cal­lous­ness, while the Dutch of­fend­ers showed greater evidence of ir­re­spon­si­bil­ity. These traits were mea­sured us­ing the PCL-R, which might be in­ter­preted dif­fer­ently in dif­fer­ent cul­tures. Nev­er­the­less, the re­search raises some in­ter­est­ing ar­eas for fur­ther study.


Be it na­ture or nur­ture, the pop­u­lar im­age of a psy­chopath is largely in­flu­enced by the am­bi­gu­ity sur­round­ing its def­i­ni­tion and di­ag­no­sis. Iron­i­cally, psy­chopa­thy is not ac­tu­ally an of­fi­cial di­ag­no­sis. In the Di­ag­nos­tic And Sta­tis­ti­cal Man­ual Of Men­tal Dis­or­ders (DSM-5) – the of­fi­cial cri­te­ria used to clas­sify men­tal dis­or­ders in the US – the clos­est con­di­tion to psy­chopa­thy is An­ti­so­cial Per­son­al­ity Disorder (APD).

“APD is char­ac­terised by im­pair­ments in per­son­al­ity func­tion­ing and by the pres­ence of patho­log­i­cal per­son­al­ity traits. How­ever, while of­fend­ers with psy­chopa­thy of­ten have APD, of­fend­ers with APD are not nec­es­sar­ily psychopaths,” ex­plains Vieira.

The clos­est thing to a check­list for iden­ti­fy­ing a psy­chopath is the PCL-R men­tioned ear­lier. This com­prises a list of 20 char­ac­ter traits and be­hav­iours – such as a lack of re­morse or guilt, fail­ure to ac­cept re­spon­si­bil­ity, shal­low emo­tional re­sponse and hav­ing many short-term re­la­tion­ships – to help de­ter­mine if an in­di­vid­ual is on the psy­chopa­thy spec­trum. How­ever, such a check­list does not serve as a ‘one size fits all’ for­mula for di­ag­no­sis. On the con­trary, psy­cho­pathic traits can be hid­den or sub­tle. In ad­di­tion, the chances are that you know peo­ple who dis­play some of these traits – that’s be­cause the ma­jor­ity of peo­ple have psy­cho­pathic ten­den­cies. In most peo­ple they may be sit­u­a­tion-spe­cific or low level, but psy­cho­pathic traits cer­tainly aren’t re­stricted to the full-blown psy­chopath.

2 “Most peo­ple with psy­cho­pathic traits blend beau­ti­fully into the fab­ric of our ev­ery­day lives,” ex­plains Dr Paul Hoke­meyer, a clin­i­cal and con­sult­ing psy­chother­a­pist based in New York.


The lack of a di­ag­nos­tic tool or a pres­ence in the DSM-5, is partly due to the mys­tery sur­round­ing psy­cho­pathic be­hav­iour. This has led to the pre­dom­i­nantly in­ac­cu­rate me­dia im­age of a psy­chopath.

“The na­ture of cin­e­matic and lit­er­ary de­pic­tions is that they over­drama­tise the traits found among psychopaths by hav­ing them bru­tally mur­der a slew of vic­tims,” says Hoke­meyer. “Top of this list in­clude Javier Bar­dem’s char­ac­ter in No Coun­try For Old Men and Chris­tian Bale in Amer­i­can Psy­cho. In real life, how­ever, psychopaths sel­dom mur­der out­right.”

Prof Sa­muel Leist­edt and Dr Paul Linkowski, foren­sic psy­chi­a­trists based in Brus­sels, in­ves­ti­gated the his­tory of the cinema-psy­chopa­thy re­la­tion­ship in 2014 by analysing 400 films and short­list­ing 126 fic­tional psy­cho­pathic char­ac­ters on the scales of re­al­ism and clin­i­cal accuracy. They found that psychopaths were of­ten car­i­ca­tured as sex­u­ally depraved and emo­tion­ally un­sta­ble, with sadis­tic per­son­al­i­ties and ec­cen­tric char­ac­ter­is­tics. Such im­ages aren’t nec­es­sar­ily re­al­is­tic; in­deed, Leist­edt and Linkowski be­lieve that cer­tain cin­e­matic psychopaths such as Nor­man Bates in Psy­cho and Travis Bickle in Taxi Driver are psy­chotics rather than psychopaths.

While psy­chopa­thy is a per­son­al­ity disorder un­der­lined by cal­lous­ness, reck­less­ness, im­pul­sive be­hav­iour, ly­ing and lack of em­pa­thy, psy­chosis refers to a men­tal state where the per­son has lost touch with re­al­ity. Psy­chopa­thy is typ­i­cally not as­so­ci­ated with any loss in the sense of re­al­ity: in­di­vid­u­als know where they are and what they are do­ing. The per­cep­tion that ‘psy­chotic’ and ‘psy­cho­pathic’ are one and the same simply isn’t the case. While the for­mer is an out­ward dis­play of a chaotic per­son­al­ity, the lat­ter is more in­ter­nal, and dif­fi­cult to spot. Far from be­ing the crazed, dam­aged in­di­vid­u­als por­trayed in the movies, there is mount­ing evidence that many peo­ple with psy­cho­pathic char­ac­ter­is­tics are highly suc­cess­ful. “Psychopaths are very good at see­ing which be­hav­iours a sys­tem re­wards and ex­hibit­ing those be­hav­iours. This is one route to ca­reer suc­cess,” says Blakey.

It is not sur­pris­ing, then, that a 2016 Aus­tralian study found that around one in five US cor­po­rate lead­ers dis­played psy­cho­pathic traits. Psychopaths may be poor at man­age­rial tasks, but they are of­ten adept at climb­ing the lad­der by hid­ing weak­nesses and charm­ing their col­leagues. An­other po­ten­tial ben­e­fit, ac­cord­ing to Blakey, is that the typical psy­chopath doesn’t care about other peo­ple’s feel­ings and there­fore they don’t feel the same com­pul­sion to pro­tect them from neg­a­tive emo­tions. As such, psychopaths find it easy to em­bark on emo­tional risks that other peo­ple might hes­i­tate to take.

So while at ex­treme lev­els psy­chopa­thy can lead to an­ti­so­cial and destruc­tive be­hav­iours, at mod­er­ate lev­els it can of­fer some ad­van­tages. The key difference is be­tween ‘clin­i­cal’ and ‘func­tional’ psychopaths. Func­tional psychopaths know in which con­text to ex­hibit their char­ac­ter­is­tics. When it comes to goals, psychopaths have laser fo­cus, per­sis­tent am­bi­tion, self-con­fi­dence and so­cial charm. Ac­cord­ing to Hoke­meyer, this func­tional as­pect of psy­chopa­thy could be the real risk to so­ci­ety.

“The most dan­ger­ous trait of psychopaths is their abil­ity to operate in stealth. On the sur­face, they can ap­pear to be warm, gen­uine and in­cred­i­bly charis­matic,” he says. “But just be­low the sur­face of their ve­neer lies a moun­tain lion wait­ing to pounce.”

Be­yond the Hannibal Lecters of the cinema, the story of the psy­chopath re­mains some­what of an enigma. Sci­en­tists know more about psy­chopa­thy to­day, based on case stud­ies and brain re­search. Yet there is still much we don’t know, and the knowl­edge we do now have is un­set­tling to many: psychopaths are not nec­es­sar­ily evil but reg­u­lar hu­man be­ings with a ‘twist’ – traits that make them adept at get­ting their own way. And they live among us ev­ery day.

ABOVE RIGHT: In the scan of the nor­mal brain, there is ac­tiv­ity in the frontal lobe (marked with an ar­row), which is as­so­ci­ated with emo­tional re­sponse; in the psy­chopath brain, there is lit­tle ac­tiv­ity in this re­gion PSY­CHOPATH


RIGHT: Some men­tal health pro­fes­sion­als have claimed that Don­ald Trump could be a psy­chopath

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