Sympathy for the Devil
Psychopathy Unveiled: From Victorian Myths to Real Minds
The haunting lyrics of the Rolling Stones’ controversial 1968 song "Sympathy for the Devil" remind me of the enigmatic allure and common misconceptions surrounding psychopathy. This condition, often shrouded in myth and dramatization, has a story deeply rooted in the annals of psychiatry and more recently illuminated by modern neuroscience.
This is the first in a series of posts in which I’ll be uncovering and exploring the complex narrative around psychopathy and correcting a few myths. Contrary to the chilling, often violent psychopaths depicted in movies and TV shows, real-life individuals with psychopathic traits might be closer and more common than you think. Prevalence estimates range from 1% to 4% or up to 1 in 25 people. Chances are, you've crossed paths with them in everyday life — charming, inconspicuous, and hidden in plain sight, far from the sensationalized extremes of popular media. So what should you be looking out for?
What’s in a name? Of Alienists and Psychopathy
Prior to the late 1800s, mental health conditions were often perceived through a moral and religious lens, with conditions ranging from depression and anxiety to addiction and psychosis seen as personal or spiritual failings, sinfully denying the grace of God at best and evidence of demonic possession at worst. The role of alienists, an early term for psychiatrists, was central in this shifting this. Alienists were so named because they treated individuals who were considered "alienated" not only from the rest of society but from their own true natures due to mental illness. Alienists played a crucial role in the transition from moralistic and religious interpretations of mental illness to a more scientific and medical approach. Their work laid the foundation for modern psychiatry, emphasizing the need for compassionate treatment and a deeper understanding of mental health conditions.
At this time, among alienists the concept of psychopathy was as broad and unfocused as the gas-lit streets of Victorian cities. Rooted in Greek, 'psyche' (soul or mind) and 'pathos' (suffering), it literally meant 'suffering soul' – a broad, almost poetic description that covered a wide range of mental disturbances ranging from severe mental illness to what we might now recognize as personality quirks. This catch-all term was a primitive attempt at understanding behaviours and mental states that deviated from the societal norms of the time, lacking the precision and specificity that modern science would later bring. So how did this change happen?
In this era of early psychiatric thought, Philippe Pinel's concept of manie sans délire (mania without delirium) and James Prichard's 'moral insanity' laid foundational ideas for understanding mental disorders that went beyond cognitive or emotional difficulties. Pinel identified patients who showed significant behavioural disturbances but did not experience hallucinations or delusions, while Prichard's 'moral insanity' described individuals displaying deeply deviant behaviour alongside rational thinking. These concepts both suggested that mental illness could manifest primarily through personality and behaviour.
In the 20th century, Emil Kraepelin’s concept of 'psychopathic inferiority' emphasized the chronic nature of what we now call personality disorders, while Kurt Schneider later narrowed the term further focussing on specific 'psychopathic personalities' characterized by traits like lack of empathy and violating social norms and laws. This evolution steered the term 'psychopathy' towards our current conception.
Hervey Cleckley’s Groundbreaking Work
Dr. Hervey Cleckley, an American psychiatrist, revolutionized our understanding of psychopathy with his 1941 book, "The Mask of Sanity." Cleckley's work was akin to turning on a bright light in a dim room. He presented detailed case studies of individuals who, on the surface, appeared charming, intelligent, and entirely normal but were lacking in fundamental emotional and empathetic capacities. Cleckley's patients work a ‘mask’ which involved mimicking normal emotional reactions, yet these displays were superficial, hiding a profound internal emptiness and an inability to form genuine emotional connections. His book was not just a clinical revelation; it was a compelling narrative that captured the public's imagination and set the stage for all future academic discussion of psychopathy.
Robert Hare’s Diagnostic Leap
Several decades later, Canadian forensic psychologist Dr. Robert Hare emerged as a pivotal figure in the field of psychopathy research. Building on Cleckley's foundational work, Hare developed the Psychopathy Checklist (PCL), a tool that brought a new level of rigour and objectivity to the diagnosis of psychopathy. What Hare did with the PCL was pretty groundbreaking. It turned Cleckley's ideas about psychopathy into something you could actually measure. The PCL lets you look at how someone acts and what they've done in the past to figure out if they've got certain psychopathic factors. It’s used in therapy offices, court cases, and research and helps tell psychopathy apart from other personality issues, which is a big deal when you're trying to get a clear picture of what (or who) you’re really dealing with.
One of the most striking aspects of Hare's view on psychopaths is his belief that they navigate the world unencumbered by conscience. It's like they're driving down the road of life without the ‘speed bumps’ of guilt or remorse that most of us endure. This doesn't mean they don't know right from wrong; it's more about not feeling the emotional weight of their actions the way others do. Imagine making decisions without the burden of worrying about the consequences for other people or ever experiencing regret – this is the essence of how Hare perceives the psychopathic mindset.
So what’s the problem here? Well, Cleckley's work encompassed a broad range of backgrounds and occupations, including both men and women. In contrast, Hare's early research was primarily conducted within prison settings and involved a population that was predominantly male. These inmates, convicted of crimes ranging from non-violent offences like fraud to serious violent crimes, presented a criminally diverse yet limited perspective dominated by anti-social examples.
This focus on a largely male, prison-based population raised important questions about the applicability and generalizability of Hare's findings. Initially, this research painted a picture of psychopathy that was closely tied to criminality, inadvertently reinforcing stereotypes of psychopaths as predominantly violent, criminal, and male. While that certainly describes some psychopaths, it’s a stigmatising and incomplete picture of the broader spectrum of psychopathic behaviour.
Recognizing these limitations, Hare and other researchers in the field later expanded their studies to a broader range of subjects including both women and non-criminal examples, and notably ‘white collar’ psychopaths in the workplace. However, that original picture lingers in the public imagination and continues to fuel popular media portrayals to this day.
In recent decades, advances in neuroimaging have further enriched our understanding of psychopathy. Modern research focuses on the neurobiological underpinnings of the condition, exploring how brain structure and function, as well as genetic factors, contribute to psychopathic traits. Studies utilizing fMRI and PET scans reveal differences in brain areas related to empathy, impulse control, and emotional regulation in individuals diagnosed with psychopathy.
James Fallon's Neurological Twist
The plot took an intriguing turn with neuroscientist Dr. James Fallon. In a narrative twist worthy of a detective novel, Fallon discovered that his own PET scans exhibited patterns identical to those in his research study of diagnosed psychopaths. This personal revelation helped bring a new layer of complexity to our understanding of psychopathy. Fallon's subsequent exploration into the neurological underpinnings of the condition led to his "three-legged stool" model which he offers in his book “The Psychopath Inside”. This model posits that a convergence of genetic factors, environmental influences, and specific brain structures contribute to the development of psychopathic traits. His work illustrates that psychopathy is not just a behavioural or psychological anomaly but also a neurobiological phenomenon, adding a critical piece to the puzzle of understanding this complex condition.
Athena Walker's Personal Narrative
Athena Walker's pseudonymous first-person account provides a vivid and personal perspective on living with psychopathy as a woman. Athena personally sought out a full diagnostic interview to confirm her self-diagnosis. Her writings on Quora from 2015 onwards offer a window into the world as seen through the eyes of someone with psychopathic traits. Walker describes her experiences and perceptions in a society that often misunderstands or fears her condition. She has talked about the challenges of navigating a world where the typical emotional cues and responses are foreign to her, including how she approaches intimate relationships. Her narrative is a powerful testament to the diversity of experiences within psychopathy. It challenges the stereotype of the "cold-blooded psychopath" and reveals the nuanced reality of managing life with a brain that processes information and emotions differently from the norm. This allows us to truly look at psychopathy as a form of neurodiversity, arguably the most stigmatised of all and subject to intense neurotypical prejudice. Athena started her own substack in 2021, Eye of the Storm, which is worth checking out for those interested since Quora has added a form of paywall that makes reading multiple posts rather annoying (in this author’s opinion).
Debunking the Myths
Dispelling the myths surrounding psychopathy is crucial. The misconception that all psychopaths are predisposed to criminal or violent behaviour is debunked by the stories of individuals like Walker and Fallon, who lead productive lives despite their neurological differences. Similarly, the idea that psychopaths are entirely devoid of emotion is an oversimplification. While emotional responses in psychopathy might be atypical or muted, it does not equate to a complete absence of feeling.
I hope I’ve helped to highlight the existence of pro-social psychopaths who warrant our understanding and sympathy in contrast to the anti-social ‘devils’. Finally, in saying all of this, I want to be clear that I have no intention to minimise the real harm that some psychopaths visit on others, just to balance out the picture so that we focus our vigilance and judgement on those who truly warrant it, something I’ll be exploring further in the later posts in this series.
Until then, see you in the comments, which remain open to all.
