When we talk about psychopaths, we all think of the faces and names of famous serial killers who have committed the worst crimes, such as guru Charles Manson, Jack the Ripper or Edmund Kemper.
But while many serial killers suffer from psychopathy, the reverse is not true: many people can exhibit psychopathic traits without committing a criminal act.
Moreover, the term “psychopath” is controversial, as it does not represent any clinical reality.
In 2006, a hearing commission from the Haute Autorité de Santé recommended to use the term “personality organization with psychopathic expression”. This terminology reminds us that it is not a mental illness in its own right, but a personality disorder with a complex origin and multiple factors.
It is for this reason that the person with a psychopathic disorder is criminally responsible for his actions, unlike a psychotic, because he is fully part of the reality of the world. He is not locked in a mental bubble that isolates him from the rest of society.
The term “psychopath” is misleading
There are many definitions of “psychopath” in medical journals: antisocial personality according to the Diagnostic and Statistical Manual of Mental Disorders established by the American Psychiatric Association (DSM-5), “personality disorder with dissociality” for WHO…
Anyway, the latest edition of the International Classification of Diseases (ICD-11), published by the WHO, offers a rather exhaustive definition: the person displays a “contempt for the rights and feelings of others, encompassing both egocentrism and the absence of empathy. »
Their manifestations are both behavioral, such as the feeling of possessing rights, an expectation of admiration from others, positive or negative attention-seeking behaviors, concern for one’s own needs and desires and comfort, but not for those of others.
As for the absence of empathy, it can manifest itself in the form of indifference concerning the difficulties that one’s actions can cause for others, deception, manipulation (by lying in particular) and exploitation of others. Physical and psychological violence is one of the consequences of the disorder, because the individual is in no way sensitive to the suffering of the other and will have no mercy to achieve his goals.
Cold indifference, contempt, violence…
ICD-10 proposed a more precise definition of what she called the “dyssocial personality” or antisocial: the individual displays a marked contempt for social obligations and a cold indifference for others. This behavior causes a considerable deviation from established social norms. He will be easily frustrated, aggressive and violent.
The report of the High Authority for Health identifies six characteristics of the psychopathic personality:
- cold indifference to others
- An irresponsible attitude and disregard for rules and social constraints
- An inability to maintain long-term relationships
- Low frustration tolerance and a weakened aggression discharge threshold
- An inability to feel guilty or learn from experiences, including punishment.
- A tendency to blame others: the psychopathic personality will find a rational and convincing explanation for their social difficulties by pointing the finger at the others who are responsible for them.
Origins still nebulous
The psychopathic disorder would concern 3% of men and 1% of women, between 20 and 30 years old. Inexplicably, psychopathic disorders seem to subside after age 40.
Although some psychopathic traits can be observed in young children, antisocial or psychopathic personality disorder is only diagnosed in adults, starting at age 18, an age when the personality is fully formed.
Little is known about the reasons for the development of such a disorder. It would seem that the disorder is transmitted in a hereditary way, via a parent who developed the disorder by excessive consumption of narcotics or alcohol. Neurological disorders or hormonal imbalance could also promote the onset of the disorder.
But at present, there is a cruel lack of studies on the subject to really determine a cause and effect link between the environment in which a “psychopath” evolves and the appearance of the disorder.
Psychopathy, a difficult disorder to treat
Death surrounds psychopaths, due to their destructive behavior towards themselves and others, and their propensity to consume alcohol and drugs excessively.
Generally, the treatment of antisocial or psychopathic personality disorder is very difficult, as no specific treatment exists, according to MSD manual. In addition, the person with a psychopathic disorder would tend to evade potential treatments, given their inability to respect the rules.
Nevertheless, certain therapies can attenuate certain personality traits such as aggressiveness and impulsivity, such as CBT (cognitive-behavioral therapies), mentalization that will help people understand and conceptualize their own mental states and those of others, with the aim of smoothing their social relationships.
Medications may also be prescribed to stabilize mood, such as lithium, valproate (an antiepileptic drug), or selective serotonin reuptake inhibitor antidepressants (SSRI).