This Article Might Actually Be Promising

Let's see, shall we?

The term, “mask of sanity”, refers back to a book written in the forties by Hervey Cleckley. For it’s time, it isn’t terrible, but it isn’t great either. The book addresses the first formation of a psychopathy checklist. It is the very checklist that Robert Hare would later steal, rewrite slightly, copyright it, and put it out as the “PCL-R”. While the Cleckley list was not great, Hare managed to make it garbage. It has to be one of the only times in history that psychology from the past was actually better than the psychology of the present. It pretty much always goes the other way.

The phrase, the mask of sanity, has persisted for some time in relation to psychopathy, and nearly always it is some ridiculous concept, such as, the mask a psychopath wears is one that hides their depravity, or some other such idiocy. In reality, the mask of sanity is about blending in. That’s it. That’s the extent of it. It’s the presentation of being a social creature, when psychopaths simply aren’t. When I hear this phrase, it is usually followed by some article that goes on to describe psychopaths as the monster in the dark, complete with fire setting, bed-wetting, and animal torture. I think this is just a hook that is used to reaffirm people’s assumptions about psychopathy. This article is titled:

Masks of Sanity (Part Four): What is a Psychopath?

Ooo, but then it has this handy little titulation

The term "psychopath" is being overused by expert commentators.

You don’t say, article… by all means, tell me more. Does this mean we have found an author without their head so far up their own behind that they are smelling the morning coffee twice? Fascinating.

If you ever watch television shows like Nancy Grace and Issues with Jane Velez-Mitchell, you have probably seen criminal profiler Pat Brown and numerous other experts commenting on sensational cases like the recent shocking murder here in Los Angeles by former reality star Ryan Jenkins of his ex-wife, model Jasmine Fiore, after which he hanged himself in a Canadian hotel room. And you may have noticed that, especially for profiler Pat Brown, almost all violent offenders seem to be "psychopaths."

Indeed, yes, I have seen this to be a common and annoying habit of these sorts, but I respect the grift. They know the word, “psychopath”, sells. They also know that nearly none of the people listening to, or reading their commentary, will have any idea what psychopathy actually is. It is a good way to bypass all the aspects of human intervention that created the monster, and go straight to the notion that the person is a psychopath, so what do you expect?

Vexing, really.

Ms. Brown, who, so far as I know is not a mental health professional, is certainly not the only one guilty of such diagnostic overgeneralization: Guest panels commonly include clinical psychologists and psychiatrists making similar proclamations. But seasoned forensic psychologists know that it is dangerous to leap to such diagnostic conclusions prior to evaluating the criminal defendant and reviewing all the facts in such cases. For example, do Ryan Jenkins' gruesome efforts to conceal his murdered victim's identity by removing both her teeth and fingers and then stuffing her into a suitcase, or Chris Coleman's apparently premeditated slaughter of his wife and two children while they slept (see my previous post), or Casey Anthony's alleged killing of her own daughter (see my prior posts) necessarily make them psychopaths?

I know he has his own answer to this, and I will see what that is in a moment, but the correct answer is, nope. None of those behaviors have a thing to do with psychopathy. Could a psychopath do them? Yes. The fact is that anyone can do these things, but the reality is that a psychopath isn’t going to do something that is emotionally motivated.

Family annihilators are pretty emotional in their deeds, and tend to be very narcissistic in their motivations. They think that the killing of their family is the only way to fix whatever problem they have, but the fix solely serves them. Not the family. Also, family annihilators are idiots. Like, seriously, do you really think you’re getting away with this? If you do, you’re dumb. Very, very dumb, and so involved in your own self-love that you can’t see the real world. You get what you deserve.

As for Casey Anthony, she was neurotypical. Not what people want to hear, I know, but they ran all the tests. She was totally normal. There are articles about this:

Casey Anthony Is Normal, That's the Problem Casey Anthony was normal. She was acting just like a 22-year-old.

Anyway, back to the article this post is about. Could those two people be psychopaths?

Possibly. But it seems that for some of these commentators, the facile label of "psychopath" can be pejoratively pinned onto just about any bad behavior--especially when it involves extreme violence, such as the recent shootings of random women at a fitness club in Pittsburgh (see my previous post.) Meanwhile, did you know that the American Psychiatric Association's official diagnostic manual (DSM-IV-TR) does not even consider "psychopathy" a legitimate formal psychiatric diagnosis?

Don’t go off the rails on me here, dude. Psychopathy has no place in the DSM, as it is not psychological. Also, even if it were, it not being in the DSM means literally nothing. It isn’t a bible, it’s an insurance repayment manual. If you are a professional, which is what you are giving sh*t to the other lady about, then you should know this. It shouldn’t even grace an article about this. It speaks to falling for ignorance, instead of facts. It is a common trope that the DSM has any bearing on the world. It doesn’t, and those that supposedly use it for the purpose it is meant to be used, should know that. Let’s see if he gets there, or if this is going to be a strike against his arguments.

The term psychopath has been kicking around since the nineteenth-century, but was popularized by psychiatrist Hervey Cleckley in his 1941 classic The Mask of Sanity: An Attempt to Clarify Some Issues About the So-Called Psychopathic Personality. For Dr. Cleckley, the psychopathic personality was initially defined by a relatively high-functioning, aggressively narcissistic, extraverted persona concealing an antisocial and latent psychotic core.

You have to understand that the concept of, “psychopathy”, when it comes to Cleckley, was based on patients in mental hospitals:

He defined the term somewhat more broadly than it is understood today, as referring to somebody who behaves in a destructive manner despite lacking overt signs of psychosis or neurosis; this is reflected in the term "mask of sanity", derived from Cleckley's belief that a psychopath can appear normal and even engaging, but that the "mask" conceals a mental disorder.[1] By the time of his death, Cleckley was better remembered for a vivid case study of a female patient, published as a book in 1956 and turned into a movie, The Three Faces of Eve, in 1957. His report of the case (re)popularized the diagnosis of multiple personality disorder in America.[2] The concept of psychopathy continues to be influential through forming parts of the diagnosis of antisocial personality disorder, the Psychopathy Checklist, and public perception.

I don’t think that there is any difficulty in understanding why a patient with DID could never be a psychopath. You cannot be a person that is genetically wired with the inability to be traumatized then become traumatized at all, let alone to the point where their personality fragments into different aspects totally outside of the individual’s understanding. A psychopath could never have DID, and a person with DID could never be a psychopath. That goes doubly true for those that claim that they have DID and one of their alters is a psychopath. Nope, they are not. There is no way an alter literally changes the brain structure and chemical processing in the brain, which is, by definition, what psychopathy is. Could someone with DID have ASPD? Yes, of course, they could. Literally anyone alive can, provided that they behave to criteria.

Anyway, my point is that Cleckley isn’t really the greatest source on psychopathy. He’s just more or less the first, and he was less terrible than Hare. Take that for what it is. I can’t say that he can be totally dismissed, but he shouldn’t be taken as some sort of infallible expert.

Whether most psychopaths are truly psychotic beneath their affable, charming, manipulative mask is dubious, as Cleckley later recognized, though some may in fact, like severe borderline, paranoid or schizotypal personalities, be compensated psychotics. Someone like Charles Manson (see my prior posts) may exemplify this semi-psychotic type.

I read something that Elinor Greenberg stated about diagnoses. I thought it was exceptionally interesting:

When I studied diagnosis, it was explained to me that we prioritize the more serious diagnosis and when that diagnosis is a chronic form of psychosis, we do not diagnose the person with a personality disorder as well. The assumption is that earlier symptoms that appeared to be signs of a personality disorder were really early signs of the psychotic disorder.

Punchline: If someone qualifies for a diagnosis of Schizophrenia, they will not be diagnosed with Narcissistic Personality Disorder as well.

https://www.quora.com/Can-a-narcissist-also-have-undifferentiated-schizophrenia/answer/Elinor-Greenberg

That makes sense to me, but apparently not everyone agrees with this, as you will find folks like this guy that are trying to see past Manson’s mental health issues and make a diagnosis regarding other parts of his personality. Manson=psychotic. That should be the end of it. Past this, you cannot know why certain aspects of his personality is what it is. It also disregards things like Manson’s avid drug use, that likely contributed heavily to his decision-making.

Based on Cleckely's conceptualization, psychologist Robert Hare developed the Psychopathy Check List (PCL-R), designed to be administered by a trained mental health professional to detect and measure the presence of psychopathy. The term "psychopath" was replaced at some point in psychiatry by "sociopath," in part to try to lessen its social stigma.

Well, that didn’t work. From my experience, people tend to have a more negative opinion regarding sociopathy than they do psychopathy. Whatever destigmatization they attempted… failure.

Also, Hare did nothing but rip off Cleckley, and he did so, right after the man died. Let’s not give Hare any praise for being a douchebag.

The World Health Organization refers diagnostically to such individuals as suffering from Dissocial Personality Disorder. But the DSM-IV-TR, the most widely accepted and utilized psychiatric diagnostic system today, employs neither of these three terms, preferring deliberately instead to dub this troublesome syndrome Antisocial Personality Disorder. So any time you hear the terms psychopath, sociopath, asocial, amoral or dissocial personality, the appropriate corresponding DSM diagnosis may (or may not) be Antisocial Personality Disorder.

Come on, man, let’s not bring the WHO into this. They have not held the most stellar of reputations lately. They are not going to do anything but drag down your whole argument… which we are getting to… when? This whole thing has been a history lesson so far, and not a very good one at that. Looking again, at another DSM reference. It is not a psychiatric diagnosis system. It is an insurance repayment manual, and the damn book will tell you that itself. Back to Elinor Greenberg:

Very accurate about the DSM5 and what it is intended to do. It is not even pretending to be useful to therapy or therapists. See page 646 where it explains it is not validated and unlikely to be useful to clinicians doing psychotherapy. It says it might be useful for research or educational purposes, but does not explain how.

https://www.quora.com/Will-the-DSM-VI-assess-psychopathy-as-a-brain-variant/answer/Athena-Walker?comment_id=215699058&comment_type=2

People need to stop lionizing this book. It is helping no one, and is providing a false sense of security to “clinicians” that are using in this manner when it isn’t meant to be.

Let’s give those terms a quick definition, shall we?

Psychopath- a genetically coded difference in the structure and chemical processing of the brain.

Sociopath- a person who is subjected to severe abuse, neglect, and/or prolonged trauma that changes the way that they are able to interact in the world.

Antisocial personality disorder- a series of behaviors that have an overall negative effect in the world. This is a behavioral diagnosis only, and does not address the cause.

Dissocial personality- Europe apparently needing to have their own special word for ASPD which likely is equally useless as the original.

Just kidding Europeans. I have no idea what the criteria are for dissocial personality disorder, and frankly, I don’t feel like looking it up at the moment.

The diagnosis of Antisocial Personality Disorder focuses primarily on observable or documented long-standing patterns of behavior such as disregard for social norms, lying, impulsivity, irresponsibility, recklessness, cruelty, violence, law-breaking, lack of guilt or remorse, etc. Psychopathy or Dissocial Personality Disorder emphasize somewhat more subjective, qualitative and inferred traits like lack of caring or empathy, easily formed but superficial interpersonal attachments, low tolerance for frustration, chronically irritable mood, absence of conscience, failure to learn from negative consequences, and defensive projection of blame onto others.

Hmm, the wording of, “defensive projection of blame”, is an interesting one. On the one hand, he is correct if he is only referring to getting out of trouble.

“I didn’t do it, that guy did”, that kind of thing. But if he means it with any emotional slant, like defensiveness to protect oneself from feeling blame, that wouldn’t apply. If I did something and am caught dead to rights, I am not going to feel any particular way about it other than, “oh well, guess I will have to do better next time”. I don’t get my feelings hurt by someone thinking I did something, nor am I going to feel guilty about whatever it is that I did.

Also, I have very high levels of tolerance for frustration. I have no idea where the idea came from that we are somehow intolerant of frustration. That would be a highly emotional state, which doesn’t apply to psychopathy. It is this sort of cognitive dissonance that creates this ridiculous confusion about what psychopathy is.

Hare's PCL-R test looks for specific characteristics such as glibness or charismatic charm, narcissistic grandiosity, need for constant stimulation, shallow affect, parasitic lifestyle, sexual promiscuity, multiple brief marriages, and extreme manipulativeness or deceitfulness.

Hare’s checklist is as useful as a chocolate teapot.

Antisocial Personality Disorder incorporates most of these symptoms and traits into its diagnostic criteria.

Yup, and it is also garbage, so well done there.

One major difference, however, is that the DSM-IV-TR requires the presence of antisocial behavior in the form of what it calls Conduct Disorder ( a pattern of destructive, aggressive, deceitful, cruel and socially defiant behavior seen as a prelude to APD in childhood and/or adolescence) with onset before the age of fifteen, and that the person receiving this diagnosis be at least eighteen years of age. ICD-10, the international diagnostic system of the World Health Organization, acknowledges a prior history of Conduct Disorder as being common, but not invariably so, and therefore not requisite to make the diagnosis of Dissocial Personality Disorder.

First of all, we are not on the DSM-IV-TR, we are on the DSM-5, and they removed that criteria like twelve years ago, so no, conduct disorder is not part of ASPD. Aren’t you a psychologist? Shouldn’t you know this? Also, dude, where is your period. That cannot be one sentence. I’m wordy, but dear lord, that is another level of wordy. Punctuate damn you!

As we have seen in certain recent cases like that of the "Craig's List Killer" (see my prior posting), it may be that some individuals are particularly skilled at masking their sociopathy and at cleverly evading detection--at least up to a point--and present no clear history of Conduct Disorder during childhood or adolescence.

Based on the premise of this article, I had hope for you sir, but you have crossed the Rubicon, and there is no saving you now. Sociopathy is not psychopathy. They aren’t remotely similar, and they are not related. Also, being a killer is not indicative of being a sociopath. It means they are a killer. Most killers are neurotypical.

I will say that by selecting “sociopath” instead of “psychopath” for this individual, the fact that he killed himself is at least a possibility. It loses some credibility, however, when we learn that he tried to kill himself when is fiancée broke up with him, but again, there is nothing that I can find that indicates that Philip Markoff was anything other than a normative human.

But I would argue that even in such unusual cases, antisocial behavior does not spring fully formed from the head of Zeus. And, if it does, it may be due to something other than psychopathy.

All right, fair, I’m intrigued, but also, ASPD and sociopathy are also not the same thing. It would have been helpful if this guy actually defined terms for himself prior to writing this. He jumps around so much, it almost makes the article meaningless.

The specific diagnostic criteria set forth by DSM-IV-TR make it clear that psychopathy, sociopathy, dissocial or antisocial personality disorder cannot and should not ever be diagnosed in a vacuum on the basis of a violent crime without having concrete evidence of there being a "pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years."

Oh, my good lord, why is this guy so obsessed with the DSM-IV? Oh… I see, it’s because this article was written in 2009, and I’m an idiot for not noticing that. All right, fair enough, I retract my criticism about conduct disorder, and his referencing the DSM-IV.

I think this paragraph makes a good argument for why conduct disorder was removed. A lot of teenagers commit violent crimes because their brains aren’t developed enough for them to realize the gravity of their actions. Conduct disorder might be a problem specifically with that person, or, it might be because of an immature brain. Immature brains are not a psychological problem. They are a biological one.

When conducting forensic evaluations of violent offenders, gathering such behavioral history is prerequisite to making a diagnosis of Antisocial Personality Disorder, as is making sure the defendant meets all the minimal diagnostic criteria for this severely stigmatizing mental disorder. And yes, contrary to what certain expert commentators proclaim, Antisocial Personality Disorder--by whatever name one uses--is a real mental disorder, and a very severe, dangerous and debilitating one at that, as Cleckley himself insisted.

Again with the conflation of ASPD and psychopathy. Also, no, it isn’t. It is a collection of behaviors that anyone can undertake given the right circumstances. An excellent example would be addicts. The sh*t people do in order to feed a habit is pretty staggering, but get that individual clean, and they are often shocked by their behavior. It doesn’t change the fact that the behaviors defined by the diagnosis of ASPD are far too generalized and adopted by anyone at any time to be recognized as anything other than human behavior. There is no need to label what is so common. Remember, fifty to eighty percent of all inmates qualify for a diagnosis of ASPD. That makes it an unremarkable essay on human behavior, not a diagnosis that should be respected.

The knee-jerk reaction of calling all violent offenders "psychopaths" is inaccurate, irresponsible, misleading and unethical.

Well, that’s true, but I’m wondering when he plans to make that argument, because we’ve all been here awhile, and so far, no argument to be seen.

According to the Handbook of (Forensic) Psychology (2003), "there are many ways that someone can be at high risk for violence that are unrelated to psychopathy.. .

Again, I agree with that, and would also posit that most violence is emotionally based, and therefore not a great deal of it has to do with psychopathy.

…This is especially true," it continues, in cases of "spousal assault, stalking and sexual violence, where violence may be related more to disturbances of normal attachment processes rather than the pathological lack of attachment associated with psychopathy."

All right, excellent. This is true, and considering this handbook came out in 2003, there may be a shift in the winds in regard to how psychopathy is perceived. I will bet, however, in the next sentence, that idea is going to go right out the window.

Indeed, there are a multitude of mental disorders associated with violent behavior, including substance abuse or dependence, bipolar disorder, dissociative disorders, narcissistic and paranoid personality disorder, and psychotic disorders. Violent behavior is multi-determined, and cannot be simplistically reduced to or conveniently explained away by glibly dismissing all such offenders as "psychopaths."

Again, this is absolutely true. I agree with this… but… and of course there is a but, I can’t help but notice that the argument appears to be, not all violence is psychopathic in nature. Not, psychopathy is not associated with violence, that would be a choice that an individual makes. There isn’t anything about psychopathy that makes a person remotely violent. But, again, 2009, and even today they still only study it in prisons, so beggars can’t be choosers, right?

In reality, the bulk of violent behavior is not engaged in by individuals meeting the current diagnostic criteria for Antisocial Personality Disorder. Psychopathy is, in my view, just one of many anger disorders, though the majority of these disorders remain officially unrecognized.

Aww… look at that… right off the cliff

Failure.

Psychopathy has nothing to do with an anger disorder. Do you have any idea how hard you have to work to get a psychopath to even notice you, let alone make one of us angry? Let me tell you, you don’t have that kind of time to waste in your life. It’s too short, and you will be frustrated the entire time without getting any results. There is a reason psychopathy is not recognized as an anger disorder, and that is because you would have to lack brain cells holding hands in order to draw that conclusion.

Ohhh… I see:

(Stephen A. Diamond Ph.D.)… is the author of Anger, Madness, and the Daimonic: The Psychological Genesis of Violence, Evil, and Creativity, with a Foreword by Rollo May (1996), and has contributed chapters to the bestselling anthology Meeting the Shadow: The Hidden Power of the Dark Side of Human Nature (1991), Spirituality and Psychological Health (2005), Forensic Psychiatry: Influences of Evil (2006)

Just another person that is trying to worm their way in to psychopathy “expert”. No deal dude. You suck at this. I was going to give you a real shot. You had the whole premise that psychopathy is overused by experts, and that shouldn’t happen, but there you go right off the rails trying to redefine it to match your specialty. That’s just disappointing.

The rest of the article you can read by clicking the link. He goes on to talk about how therapeutic intervention for psychopaths failing is anecdotal, and I can tell him, no it isn’t. We do not want to be different than we are, and there is nothing that we need from therapy. He would know this if he had ever, in a single moment of his life, spoken to a real psychopath, and known about it. Clearly that either isn’t the case, or, and this is much more likely, he has decided that it doesn’t matter what we say about us, he knows us better than we do ourselves.

He also associates psychopaths with “dangerous individuals”. Too bad, I was hoping for something useful here, but yet again, I am stymied by arrogant ignorance.

What do you guys want me to write about? Let me know in the comments section.