The Wisdom of Psychopaths (8 page)

So should we be overly worried? Should it be cause for concern when the head of the most powerful nation on earth shares, as Jim Kouri noted, a significant proportion of his core personality traits with serial killers? Maybe. But to see where Lilienfeld, Rubenzer, and Faschingbauer are coming from with their political personality profiles, we need to dig deeper into precisely what it means to be a psychopath.

You need to be very careful when talking about personality disorder. Because everyone’s got one, right? So let’s get it straight from the start: personality disorders are not the preserve of those who piss you off (a common misconception among narcissists). Instead, as the
Diagnostic and Statistical Manual of Mental Disorders
⁵
defines them, they are “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it.”

The key word here is
enduring
. A personality disorder is not just for Christmas (though Christmas does, admittedly, bring out the best in them). No, personality disorders are characterized by deeply ingrained, inflexible patterns of thinking, feeling, or relating to others, or by the inability to control or regulate impulses that cause distress
or impaired functioning. They may not be exclusive to those who piss you off. But if someone’s got one, they will.

DSM classifies personality disorders into three distinct clusters.
⁶
There’s odd/eccentric, dramatic/erratic, and anxious/inhibited. And, believe you me, they’re all there. The cat-infested, crystal-gazing aunt with the tea-cozy hat and the big, dangly earrings, who thinks her bedroom is teeming with “presences” and that the pair across the road are aliens (schizotypal); the bling-toting, permatanned pool attendant, who’s had so much Botox he makes even Mickey Rourke look normal (narcissistic); and the cleaning lady I once hired, who, after three excruciating hours, was still working on the damn bath, for Christ’s sake (obsessive-compulsive). (I was paying her by the hour. So who was the crazy one there? I wonder.)

But personality disorders don’t just cause trouble in everyday life. They draw a good deal of fire within clinical psychology, too. One bone of contention revolves around the word “disorder.” With an estimated 14 percent of the general population diagnosed with one, the question arises as to whether, in fact, we should be calling them “disorders” at all. Might not, in reality, “personalities” be a better description? Well, maybe. But perhaps we should ask what personality disorders are, exactly. Do they, for instance, comprise a separate archipelago of pathology, epidemiologically adrift off the coast of mainland personality? Or do they, in contrast, form part of the Big Five peninsula: remote outposts of temperament at its darkest, most storm-battered fringes?

Support for this latter, anti-separationist view comes from a wideranging survey conducted by Lisa Saulsman and Andrew Page in 2004. Saulsman and Page scoured the clinical literature—studies that looked, in turn, at the relationship between each of the ten personality disorders listed in DSM on the one hand, and each of the Big Five personality dimensions on the other—and chucked what they found into one big melting pot of data. Analysis revealed that all ten personality disorders can be accounted for within the framework of the Big Five model.
But, crucially, it was an overriding “Big Two” that did most of the heavy lifting: Neuroticism and Agreeableness.

To illustrate, Saulsman and Page found that disorders particularly characterized by emotional distress (e.g., Paranoid, Schizotypal, Borderline, Avoidant, and Dependent) display strong associations with Neuroticism, while those typified by interpersonal difficulties (e.g., Paranoid, Schizotypal, Antisocial, Borderline, and Narcissistic) fall down, perhaps not surprisingly, on Agreeableness. Also implicated, but to a somewhat lesser degree, were the dimensions of Extraversion and Conscientiousness. Disorders either side of what we might call the Socialite-Hermit divide (Histrionic and Narcissistic, on one; Schizoid, Schizotypal, and Avoidant on the other) posted, respectively, high and low scorecards on Extraversion. Those either side of the Easy Rider–Control Freak border (Antisocial and Borderline in one camp versus Obsessive-Compulsive in the other) were similarly bipolar when it came to Conscientiousness.

The case seems pretty convincing. If the omnipotent Big Five comprise our personality solar system, then the rogue constellation of disorders certainly forms part of the firmament. But where, once again, does that leave psychopaths?

Psychopathy—like personality itself—first appears on the radar, in exquisitely mischievous though wholly unmistakable form, amidst the musings of the ancient Greeks.
The philosopher Theophrastus (c. 371–287
B.C.)
, the successor to Aristotle as head of the Peripatetic school in Athens, delineates, in his book
The Characters
, a coruscating caseload of thirty moral temperaments. One of the assembled rings several cacophonous bells.

“The Unscrupulous Man,” Theophrastus laments, “will go and borrow more money from a creditor he has never paid … When marketing he reminds the butcher of some service he has rendered him, and, standing near the scales, throws in some meat, if he can, and a
soupbone. If he succeeds, so much the better; if not, he will snatch a piece of tripe and go off laughing.” And go off laughing he did. But fast-forward a couple of thousand years, to the early nineteenth century, and the unscrupulous man returns, this time as one of the key metaphysical players in the debate over free will. Could it possibly be the case, philosophers and physicians conjectured, that certain moral transgressors, certain unconscionable ne’er-do-wells, weren’t simply “bad,” but were, in fact, in contrast to other miscreants, possessed of little or no understanding of the consequences of their actions? One of them certainly thought so.

In 1801, a French physician by the name of Philippe Pinel scribbled in his notebook the words
manie sans délire
after looking on in horror as a man coolly, calmly, and collectedly kicked a dog to death in front of him. Later in that same year, Pinel was to compile a meticulous, comprehensive—and, to this day, highly accurate—account of the syndrome. Not only had the man in question exhibited not the slightest flicker of remorse for his actions, he had also, in most other respects, appeared perfectly sane. He seemed, to coin a phrase that many who have since come into contact with psychopaths concur with, to be “mad without being mad.”
Manie sans délire
.

The Frenchman, it turned out, wasn’t alone in his ponderings.
The physician Benjamin Rush, practicing in America in the early 1800s, provides accounts similar to Pinel’s, of equally abhorrent behaviors and equally untroubled thought processes. To the perpetrators of such actions, Rush accords an “innate preternatural moral depravity,” in which “there is probably an original defective organization in those parts of the body, which are occupied by the moral faculties of the mind.”

The will, he continues, might be deranged even in “many instances of persons of sound understandings … the will becom[ing] the involuntary vehicle of vicious actions, through the instrumentality of the passions.”

He anticipated modern neuroscience by a couple of hundred years. The neural tsunami of madness need not, in other words, wash
apocalyptically up on the crystalline shores of logic. You can be sound of mind and “unsound,” simultaneously.

Spool forward a century and a half, and across the Atlantic, at the Medical College of Georgia, the American physician Hervey Cleckley provides a more detailed inventory of
la folie raisonnante
.
In his book
The Mask of Sanity
, published in 1941, Cleckley assembles the following somewhat eclectic identikit of the psychopath. The psychopath, he observes, is an intelligent person, characterized by a poverty of emotions, the absence of a sense of shame, egocentricity, superficial charm, lack of guilt, lack of anxiety, immunity to punishment, unpredictability, irresponsibility, manipulativeness, and a transient interpersonal lifestyle—pretty much the picture that twenty-first-century clinicians have of the disorder today (though with the aid of lab-based research programs, and the development of techniques such as EEG and fMRI, we’re now beginning to get a better understanding as to why). But interspersed in Cleckley’s portrait are the brushstrokes of what looks like genius. The psychopath is described as having “shrewdness and agility of … mind,” as “talk[ing] entertainingly” and possessing “extraordinary charm.”

In a memorable passage, Cleckley describes the innermost workings of the minds of these social chameleons, the day-to-day life behind the icy curtain of unfeeling:

The psychopath, it’s been said, gets the words, but not the music, of emotion.

I got a distinct taste of what Cleckley was driving at in one of my very first encounters with a psychopath. Joe was twenty-eight, better-looking than Brad Pitt, and had an IQ of 160. Why he’d felt the need to beat that girl senseless in the parking lot, drive her to the darkness on the edge of that northern town, rape her repeatedly at knifepoint, and then slit her throat and toss her facedown in that Dumpster in a deserted industrial park is beyond comprehension. Parts of her anatomy were later found in his glove compartment.

In a soulless, airless interview suite smelling faintly of antiseptic, I sat across a table from Joe—a million miles, and five years, on from his municipal, blue-collar killing field. I was interested in the way he made decisions, the stochastic settings on his brain’s moral compass—and I had a secret weapon, a fiendish psychological trick up my sleeve, to find out. I posed him the following dilemma:

A brilliant transplant surgeon has five patients. Each of the patients is in need of a different organ, and each of them will die without that organ. Unfortunately, there are no organs currently available to perform any of the transplants. A healthy young traveler, just passing through, comes into the doctor’s office for a routine checkup. While performing the checkup, the doctor discovers that the young man’s organs are compatible with all five of his dying patients. Suppose, further, that were the young man to disappear, no one would suspect the doctor. Would the doctor be right to kill the young man to save his five patients?

This moral conundrum was first put forward by Judith Jarvis Thomson, the author of the fat-man-and-trolley experiment we discussed in
chapter 1
. Though certainly a talking point, it’s pretty easily resolved by most people. It would be morally reprehensible for the doctor to take the young man’s life—no physician has the right to kill a patient, irrespective of how humane or compassionate the justification
may seem at the time. It would be murder, plain and simple. But what would someone like Joe’s take on it be?

“I can see where the problem lies,” he commented matter-of-factly when I put it to him. “If all you’re doing is simply playing the numbers game, it’s a fucking no-brainer, isn’t it? You kill the guy, and save the other five. It’s utilitarianism on crack … The trick’s not to think about it too much … If I was the doctor, I wouldn’t give it a second thought. It’s five for the price of one, isn’t it? Five bits of good news—I mean, what about the families of these guys?—against one piece of bad. That’s got to be a bargain. Hasn’t it?”

“They do emotions by numbers,” one senior forensic psychiatrist told me as we sat in his office talking about psychopaths. In Joe’s case, it would seem, quite literally.

The psychopath’s powers of persuasion are incomparable; their psychological safecracking abilities, legendary. And Joe, the killer, the rapist, with his arctic blue stare and genius-level IQ, was certainly no exception to the rule. Sometimes, in fact, when you talk to a psychopath in interview, it can be difficult to believe that there’s anything wrong at all—if you don’t know any better. Which is just one of the reasons why coming up with a precise classification of the disorder on which everyone is agreed has proven so tricky down the years.

It’s been three decades now since psychopathy got its clinical residence permit.
In 1980, Robert Hare (whom we met in
chapter 1
) unveiled the Psychopathy Checklist, the inaugural (and to many, still the best) test for detecting the presence of the disorder.
The checklist—which, in 1991, underwent a facelift: it’s since been renamed the Psychopathy Checklist–Revised (PCL-R)—comprises a twenty-item questionnaire carrying a maximum score of 40 (on each item, an individual can score either 0, “doesn’t apply”; 1, “applies somewhat”; or 2, “fully applies”), and was developed by Hare on the
basis of both his own clinical observations, and those previously identified by Hervey Cleckley in Georgia.

Most of us score around 2. The entry level for psychopaths is 27.
⁷

Perhaps not surprisingly, given the way personality theorists like to do things, the 20 items that make up the PCL-R have, on numerous occasions, just like the 240 items that comprise the NEO, been subjected to the statistical card-shuffling game that is factor analysis. The results of the game have varied over the years,
but recent activity by a number of clinical psychologists suggests that, in exactly the same way that there exist five main dimensions of personality space in general, there lurk four main dimensions in the spectral psychopath nebula nested mercurially within it (see
figure 2.6
).