Wednesday, January 28, 2009

Silence of the Lambs

In April of 1999, Rebecca Horton wrote this paper, entitled "The Sociopath".

Sociopaths have always existed in varying form and to various degrees. They have been known by various titles. They have been studied using various techniques, and through the years their ailment has been blamed on various causes. But one thing never varies: all sociopaths share three common characteristics. They are all very egocentric individuals with no empathy for others, and they are incapable of feeling remorse or guilt.

Sociopathology has been studied throughout history since at least the early 19th century. During much of that time, this type of mental illness was known as psychopathology. In 1930, G.E. Partridge proposed that the title of psychopath be changed to sociopath, for he viewed this illness as a social problem instead of just a mental illness. In 1952, the American Psychiatric Association acted on this suggestion by officially replacing the term psychopath with the term sociopath. But to this day, these two terms are used interchangeably (Culwell, 1998).

These terms actually have slight differences in their meanings. According to C.R. Bartol, "The term psychopath is usually used to describe a mental illness, the sociopath is an individual who habitually violates known norms and laws" (as cited in Culwell, 1998, p.2). The main difference between the two is the consistent criminal behavior of the sociopath. Therefore, "all sociopaths are psychopathic, while not all psychopaths are sociopathic, due to the absence of the overt criminal behavior that defines sociopathology" (Culwell, 1998, p.2).

In 1968, the American Psychiatric Association once again changed the title of this illness and merged these two previous terms under the label of antisocial personality disorder (APD). According to the DSM III (1980), DSM III-R (1987), and DSM-IV (1994), diagnostic manuals which have been used by psychologists and psychiatrists through the years, the antisocial personality disorder refers to an individual "in which there is a history of continuous and chronic antisocial behavior in which the rights of others are violated" (as cited in Culwell, 1998, p.2). The World Health Organization labeled this disorder in the ICD10 as dissocial personality disorder (Sabbatini, 1998). These terms group the psychopath and sociopath into a single personality disorder that can be tested and measured.

Through the years, several characteristic trait descriptions and tests have been created to more easily label the sociopathic individual. The 22-item Psychopathy Checklist-Revised (PLC-R) created by Dr. Robert Hare, the noted Canadian researcher on the psychopathic personality located at the Hare Lab at the University of British Columbia, is presently considered one of the most valid and respected tests in the field of psychology. This test provides a numerical measurement of the degree of psychopathy in an individual. This score is based on two factors, the attitudes and feelings of the individual and the socially deviant behavior of the individual (Culwell, 1998; Hare, 1995).

Sociopathy can be recognized early in an individual. Before the age of around 15 - 16 years, a child showing sociopathic traits is titled with conduct disorder. Signs of this early stage of sociopathy might include immunity to parental punishment and pain. Other signs may be the torturing of animals, fire setting, vandalism, consistent lying, theft, or aggression towards others. Nothing usually works in trying to change the behavior of this type of child. Therefore, the parent(s) usually give up, making the situation worse. But it must be noted that many children with conduct disorder do not progress on to sociopaths. After the age of 15 - 16, those who continue to show sociopathic signs are then labeled as having sociopathy or antisocial personality disorder (Carter & Golant, 1998; Sabbatini, 1998).

Sociopaths are very egocentric individuals that lack a sense of personal responsibility and morality. They may be impulsive, manipulative, reckless, quarrelsome, and consistent liars. Sociopaths are usually unable to sustain relationships and have a total lack of remorse for their actions. The sociopath may also be very prone to aggressive, hostile, and sometimes violent behavior. This aggression may or may not lead to criminal behavior and often takes the form of domestic violence. Along with these other actions, sociopaths often engage in self-destructive behavior such as alcoholism or addiction to drugs. This, of course, usually worsens many aspects of the sociopathic behavior. Despite these previous symptoms, the sociopath may be an excellent actor, always appearing charming, calm, and collected. They usually have a normal or above normal intelligence level and good verbal fluency. It is these qualities that sometimes place the sociopath in leadership positions within their social groups and often make it hard to spot their "black side".

According to Dr. Robert Hare, there are three main categories of psychopaths. Primary psychopaths/sociopaths are considered to be the true sociopath. This is the sociopath who appears to be very normal, calm, and educated on the exterior, but on the interior, they are incapable of experiencing any form of emotional content. They rarely come in contact with the law, but when they do, they are often able to talk themselves out of trouble using their verbal skills. Despite this verbal eloquence, the words often have no real emotional meaning for the sociopath. When the primary sociopath does commit crimes, they are usually petty, meaningless, and without logic, such as daredevil acts and disturbing the peace. It is believed that a constant state of boredom and the lack of ability to truly feel deep emotion are what lead to this random misbehavior or thrill seeking. This form of psychopaths "can basically be thought of as emotional shells; the surface is all there, but there is no substance" (Culwell, 1998, p.7).

The second category is the secondary, or neurotic, psychopath/sociopath. This type of individual has much more severe and noticeable emotional problems. According to Dr. Curt Bartol, they are sometimes referred to as "acting-out neurotics" (as cited in Culwell, 1998, p.8). This individual displays much greater antisocial behavior and is much more likely to come into contact with the law (repeatedly). They are at a much greater risk of imprisonment.

The third type of psychopath/sociopath is the dyssocial psychopath. "Dyssocial psychopaths can be said to have come about primarily due to Bandura's Social Learning Theory and his model for observational learning. They were effectively made antisocial by their environment" (Culwell, 1998, p.8). This category of sociopathy is much rarer and therefore has been researched much less.

The causes of this sociopathic disorder have been narrowed to several factors through research. One of the primary causes of sociopathic behavior is believed to be neurological abnormalities mainly in the frontal lobe of the brain. This area of the brain is responsible for "self-control, planning, judgment, the balance of individual versus social needs, and many other essential functions underlying effective social intercourse" (Sabbatini, 1998, p.7). This area is also related to fear conditioning. The abnormal anatomy or chemical activity within this area of the brain may be caused by abnormal growth (possibly genetic), brain disease, or injury. This theory has been supported by much research using positron emission tomography (PET) which visually shows the metabolic activity of neurons within the brain (Sabbatini, 1998). A second factor believed to be partially responsible for the sociopathic disorder in some cases is the primary socialization of individuals within dysfunctional environments, such as abusive, poorly educated, or poverty stricken homes. For years, this was thought to be the primary cause of sociopathy. But as knowledge has increased in the area of neuroscience, it has been realized that this is possibly only a secondary cause. Therefore, it can be said that the type of brain the sociopath was born with and/or the environment in which it was nourished forms the sociopath (Andreasen, 1984).

An estimated 3% of all adult males have this sociopathic disorder. (The antisocial personality disorder is uncommon among women.) Only a small fraction of this percentage actually develop into violent criminals. Most sociopathic individuals are able to control their disorder within the boundaries of social tolerability (Silver & Yudofsky, 1992; Sabbatini, 1998).

They are considered only 'socially obnoxious' or hateful personalities, and every one of us knows of someone who fits the description. Corrupt and callous politicians, social or career fast climbers, authoritarian leaders, abusing and aggressive persons, etc., are among them. A common characteristic is that they engage systematically in deception and manipulation of others for personal gain. In fact, many successful and adapted non-violent sociopaths can be found in our society. An NIMH epidemiologic study reported that only 47% of those who met the SPD criteria had a significant arrest record. The most relevant events for these persons occur in the area of job problems, domestic violence, traffic offenses, and severe marital difficulties. (Sabbatini, 1998, p.2-3)

More easily recognized and studied are the sociopathic individuals with histories of violent criminal behavior. As much as 15-25% of society's inmate population show many traits of this disorder (Hare, 1995,- Sabbatini, 1998). It is these incarcerated individuals as well as individuals in mental institutions on which most of the research on antisocial personality disorder is based.

As can be seen, sociopaths can exist in many different forms and to many different degrees. They can also be found in all races, cultures, and socioeconomic levels. The sociopath could be the intelligent and very successful businessman that goes home each night and abuses his family. He could be the temperamental man that visits the bar regularly and who often gets into brawls. The sociopath could be the prison inmate who was just released last month, and who is already back in prison or the hateful man that lives on the block that no one seems to be able to get along with. He could be that career-climbing businessman or politician that doesn't care who they destroy in the process. It could even be that man that can't seem to get enough of adrenaline-pumping adventures like bungee jumping, skydiving, and motorcycle racing. Or, he could be that quiet, polite man that no one ever suspected was a serial killer.

The terms sociopath or psychopath often bring to mind images of sadistically violent individuals such as Ted Bundy or the fictional character of Dr. Hannibal "The Cannibal" Lecter in the book and movie The Silence of the Lambs. But I believe the defining characteristic traits of sociopaths actually cover a much broader spectrum of individuals than most of us would ever imagine. The sociopath is that truly self-absorbed individual with no conscience or feeling for others and for whom social rules have no meaning. I believe that most all of us know or have come in contact with sociopathic individuals without even knowing it.





References

Andreasen, N.C., Ph.D. (1984). The Broken Brain: The Biological Revolution in Psychiat . New York: Harper & Row Publishers.

Carter, R., & Golant, S.K. (1998). Helping Someone with Mental Illness: A Compassionate Guide for Family, Friends, and Caregiver. New York: Random House Inc.

Culwell, S. (1998). Psychopathology and Antisocial Personality Disorder. Retrieved March 10, 1999 from the World Wide Web: http://www. flash.net/-sculwell/psychopathology.htm

Hare, R.D. Ph.D. (1995). Internet Mental Health: Psychopaths: New Trends in Research. Retrieved April 22, 1999 from the World Wide Web: http://www. mental health. com

Oldham, J.M. MD, & Skodol, A.E. MD (1992). Personality Disorders. In The Columbia University College of Physicians and Surgeons Complete Home Guide to Mental Health (pp. 182-191). New York: Henry Holt & Co.

Sabbatini, R.M.E., Ph.D. (1998). Brain Diseases: The Psychopath's Brain. Retrieved March 10, 1999 from the World Wide Web: http://www.epub.org.br/cm/nO7/doenca5/diseas_ i.htm

Silver, J.M. MD, & Yudofsky, S. MD (1992). Violence and Aggression. In The Columbia University College of Physicians and Surgeons Complete Home Guide to Mental Health (pp. 385-393). New York: Henry Holt & Co.

Wagman, R.J. (Ed.). (1993). Mental and Emotional Disorders. In The New Complete Medical and Health Encyclopedia . (Vol. 3). Chicago: J.G. Ferguson Publishing Company.

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1 comment:

saddy said...

I have a major problem with that requirement for a diagnosis of conduct disorder in youth. If sociopathy is a spectrum (which it appears to be with some individuals badly affected and others able to function quite highly) then it seems reasonable to me that many sociopaths would have managed to hide the worst of their character (particularly in youth when peer relationships are so important). I was married to a man who I believe is one ... no conduct disorder at all - I don't feel it is necessary or helpful to have that as a diagnostic marker. After all we now know many sociopaths are high functioning and fill the best positions in companies and organisations - they are not in jail as was once assumed. I read last night that the condition has a genetic basis, being passed to the son from the mother and this certainly makes sense in my case. Mother is like a photocopy - same behaviours, mannerisms, same problems and lack of insight. I am enjoying your writing and very grateful that women such as yourself are publically telling their story. It is so hard to live through the relationship and the aftermath - knowing you are not alone and others understand really helps. Thanks :)