BBC Science Focus

NICOLA DAVIES

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?

- 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,

“MOST PSYCHOPATH­S HAVE TRAITS THAT BLEND INTO THE FABRIC OF OUR LIVES”

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.

BORN TO BE VILE?

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.

A TOUGH CALL TO MAKE

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.

MURDEROUS MINORITY

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.

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

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