Psychopath or Psycho?
Psychopaths are not disoriented or out of touch with reality, nor do they experience the delusions, hallucinations, or intense subjective distress that characterize most other mental disorders...
Unlike psychotic individuals, psychopaths are rational and aware of what
they are doing and why.
Their behavior is the result of choice, freely exercised.
Dr Robert Hare
Without Conscience: The Disturbing World of the Psychopaths Among Us
Defining Psychopathy
It is an unfortunate myth that psychopaths are all crazed and bloodthirsty serial killers, suffering delusions such as hearing voices, or being driven by crazed desires to don other peoples' skin etc.
The confusion has arisen because of the popularity of movies like ‘Psycho’ and slasher fare typified by ‘The Texas Chainsaw Massacre’ with a loopy, blood-crazed anti-hero, Leatherface.
It is true that many psychopaths commit violent crimes, but:
- Not all psychopaths are criminals
- Not all criminals are psychopaths
What’s more, some psychopaths suffer psychosis too – ie they are psychotic...
Confused? It’s not surprising as the popular jargon has rather muddied the water.
Psycho in a nutshell
Psychotic means suffering from psychosis. The abbreviation ‘psycho’ comes from this term - as in he's psycho meaning he's crazy.
In reality psychosis is a psychiatric condition related to mental health. It is characterized by delusions, hallucinations, incoherence, and distorted perceptions of reality.
A schizophrenic suffers from these symptoms. Mathematician John Nash is a perfect and accessible example: ‘A Beautiful Mind’, the biopic with Russell Crowe, depicted Nash in a sympathetic manner in a very suspenseful and thought provoking way. The movie gives the viewer an understanding of this devastating condition.
So, psychotic and psycho describe the realms of imaginary friends, auditory and visual hallucinations and disordered thinking. This can lead to dangerous behaviours, especially if the person has paranoia too, ie is a paranoid schizophrenic.
A psychotic break can occur completely unexpectedly, even in normal people. (In my crime thriller novel Remorseless the protagonist, a forensic psychiatrist, is traumatized by a fatal car accident and suffers psychosis as a result, but it is a purely temporary phenomenon, ie a psychotic break.) This is often brought on by extreme stress, and may result in a violent episode like the one described in this 2011 article from the UK's Guardian Newspaper:
The day Dad attacked Mum with an axe
As a 16-year-old, Henry Johnson had always seen his father as strong, caring and protective. But then he witnessed an out-of-the-blue attack that ripped his comfortable world apart...
Click here to read the full story.
However, psychotics are largely harmless to society, being generally more dangerous to themselves, although they do occasionally resort to violence on others.
Mad not bad
People unfortunate enough to suffer from psychosis may not be aware they are doing anything wrong – and hence will be found not guilty of a crime but legally insane instead.
Criminals who have been charged with heinous crimes often try to use this as a defence ploy in the hope that the sentence will be less severe, with the possibility of eventual release (see Issei Sagawa and others in the Quotes section for more).
The term psychotic is very specific - but psychopath is also clearly defined.
Psychopaths
You'll find more information on this site but for this section it is enough to know that rational people, suffering no psychosis, make up the majority of psychopaths. The defining characteristics are:
- A lack of conscience
- Shallow emotional affect
- Selfishness
- Empathy is absent
- Superficially charming
Psychopaths generally appear normal and rational, unlike psychotics, and may be very successful in their chosen field - doctors, judges, bankers, politicians...
They are found in every walk of life, and are especially successful in competitive professions – in part because they are ruthless, manipulative and can be wilfully destructive if they think it will benefit them.
They are well aware of the difference between right and wrong – they just do not care.
A quick example of the difference between a psychopath and a normal person is illustrated by a straightforward brain imaging test performed by Dr Hare. Different parts of the brain react to words or images, depending on the emotional content.
Tree vs Rape
Hare discovered that a normal reaction to the emotive word rape stimulates a different part of the brain to the word tree which lacks any emotional attributes.
In a psychopath the response is the same: in other words there is a total absence of the emotional connection that appears in a normal person.
This emotional dead zone partly explains why psychopaths can be totally detached - even when confronted with, or participating in, the most horrific, violent acts - indulging in cannibalism for instance. Such things are not abhorrent to them in the way they are to normal folk because there is no emotional connotation affecting them.
So, it is not surprising that the term psycho is often misused to describe the worst deeds a psychopath may undertake; to a normal person, actions such as murdering and then dismembering your own mother seem insane - yet these are not necessarily the acts of a madman. Just the acts of a violent psychopath who will have a 'rational' explanation for what he has done.
Making him legally sane.
Bad not Mad
In Britain one person in 100 is likely to be an extreme psychopath, with maybe another one or two percent borderline, yet genuine psychopaths are responsible for the majority of all reported crimes, especially violent crimes, and make up around 20% of the prison population. The figures may be higher in the US.
The video documentaries listed here are well worth watching if you are interested in understanding more on this subject, especially with regard to the prospects for treatment of this antisocial cohort.
Psychopaths create a far greater proportion of destruction and havoc than such a small percentage of the population should, yet have received little attention.
That is now changing.
The videos include interviews with criminal psychopaths responsible for appalling acts, and throw light on what motivated them in their violent and destructive behaviour.
More revealingly, you can see first hand how they lack the range of emotions experienced by the rest of us, and are clearly untroubled by conscience.
Even if you watch just the first few minutes of the Iceman or Equinox videos you will gain a chilling insight into this type of personality.
Psychopathy Checklist Scores
Robert Hare, Professor of Psychology at the University of Vancouver, created various versions of the Psychopathy Checklist, the internationally accepted standard used to determine a psychopathic character.
Mental health professionals assess these individuals for a series of character traits, including callousness, superficial charm, lack of empathy and many others and grade them on a scale of 0 to 40.
A score higher than 30 is diagnosed as psychopathic.
A normal person would score around 2...
They are very different creatures to you and I.