Criminal Psychopathy

Journal of Medical Ethics, 1991

Although the concept ofpsychopathy retains its currency in British psychiatry, apparently being meaningful as well as useful to practitioners (1), it is often taken to refer to a purely legal category with social controlfunctions rather than a medical diagnosis with treatment implications. I wish, in this briefarticle, to suggest that it is essentially, and most usefully, an ethical category which stands outside the diagnostic framework ofpresent-day psychiatry. The clinical background Even in clinical contexts, the existence of a type of individual who does not regard others as having moral claims upon him, or her, has long been recognised. In modern psychiatry the idea is closely linked to the development of the concept of moral insanity which took place during the eighteenth century. Although at that time, as Werlinder (2) reminds us, the term 'moral' had nuances ofmeaning relating to the feelings, or passions, rather than to ethics, it seems that alienists sometimes used the term ambiguously, and quite often specifically to mean 'ethical'. Benjamin Rush, often credited with the first attempt to explicate the concept of moral insanity, is a case in point, referring to 'diseases of the moral faculty defined as a power to distinguish and choose between good and evil' and coining the term 'anomia' to include all cases in which there was a total absence of conscience (3). In Britain, a distinction was sometimes made between the terms 'moral' and 'medical', and between 'moral' and 'mental'. Cases of disregard for prevailing moral norms were subsumed in Prichard's 1835 concept of moral insanity (4), and whilst he did not intend that morality be completely annexed by medicine he certainly wanted the boundaries between them to be moved so that some aspects of behaviour hitherto regarded as forms of depravity would fall into the category of moral insanity. He stressed that true moral depravity and moral insanity were quite distinct, however, on the grounds of the 'undoubted' corporeal Key words Moral insanity; psychopathy; psychopathic disorder; mentally abnormal offendarsoclopathy.

Psychopathy - New Updates on an Old Phenomenon, 2017

Psychopathy is the result of the bundle of personality characteristics that typically displays socio-communicative impairment as well as restricted social skills and activities in which neurophysiological impairments are reported. The most prominent feature of psychopathy is that communication failures occur in interpersonal relations due to insincere charm for manipulations, grandiose self-perception, rule-breaking tendencies, irresponsibility and unpredictable impulsive behaviors. Since the individuals with psychopathic traits are very self-centered, they act on their emotional state. Their behaviors are driven by feelings and impulsive wishes. That is why, they are untrustable individuals. They have lots of difficulty and are considered to be dangerous in maintaining long-term relationships, particularly with their intimate partner. It is a critical mistake to assume that psychopathy is caused by the individual's incomplete individuality. This mistake leads to inability to be eliminated of the problems in not only correctional interventions in forensic settings but also treatment procedures in clinical settings. In this chapter, the characteristics of psychopathy are explained for providing some inspiration in the line of successful treatment procedures and intervention strategies in forensic and clinical settings.

The concept of psychopathy is unlike most other mental disorders in the lack of observations of vulnerability and pain in those affected. Rather, the psychopath’s callous and self-centered ways are known to evoke suffering in others. Measures are developed to identify these characteristics in a reliable way. However, increased accuracy has not led to better treatment. As a consequence, this study aimed to investigate whether the current understanding of psychopathy is changing, or should be changed, and if central changes in the concept and measurement of psychopathy require a modification of the way we handle the problem today? Hallmarks of the current paradigm were challenged through 3 research questions: 1. Are psychopathy and suffering mutually exclusive constructs? 2. Is the psychopath more than the persistent callous, grandiose and ruthless characteristics that we usually see? 3. Is the psychopath deprived of a capacity to change? The first article of the thesis reviews previously published (1980-2009) cases of offenders with severely psychopathic traits (n=11). Vulnerability and pain in psychopaths were consistent with empirical evidence and concepts associated with object relations theory, Reid (1986) and Martens’ (2002) clinical experience of suffering in psychopaths, and comorbid symptom- and personality pathology, as indicated by the authors’ assessment and the selfreport of individual offenders. Articles two and three draw from an in-depth investigation of Norwegian high-security and detention prisoners with possible and strong indications of psychopathy (n=16) and controls (n=35). Results indicate important nuances in psychopathic offenders’ affective and interpersonal functioning in terms of relational uncertainties and pain, and a greater emotional range than what is previously reported. Results further indicate a link between empirical findings and clinical theory describing structural affective, relational and defensive nuances in pathologically extreme self-states, which should be considered in future treatment of psychopathy. Results are incongruent with Cleckley’s (1941; 1988) recognized description, and the wellestablished primary-secondary psychopathy distinction (Karpman, 1941), and in agreement with the dimensional model of self- and interpersonal functioning advised in APA’s (2010) proposed revision of personality diagnoses. Future work should focus on the vulnerability and suffering, nuances and adjacent treatment of psychopathy. Such an approach would represent a paradigm shift in this field.

Extended Essay FHS of Physiological Sciences 2012 Word Count: 2997 Theme: A8 -Neuroscience: Biology of Brain Disorders 950412 2

Mind & language, 2005

Psychopaths are renowned for their immoral behavior. They are ideal candidates for testing the empirical plausibility of moral theories. Many think the source of their immorality is their emotional deficits. Psychopaths experience no guilt or remorse, feel no empathy, and appear to be perfectly rational. If this is true, sentimentalism is supported over rationalism. Here, I examine the nature of psychopathic practical reason and argue that it is impaired.

Psychopathology, 2015

The objective of this study is to present a theoretical paper about a clinical issue. Our aim is to propose some clinical and semiological considerations for a psychopathological conception of psychopathy. We will discuss several major theoretical works dedicated to this nosographic entity (mainly those of Schneider, Cleckley and Hare). We will also examine a significant issue raised by Cooke et al., namely whether psychopathic functioning is consistently related to antisocial behavior. This theoretical essay is informed by clinical situations (involving psychopaths who were interviewed in prison or in forensic centers). The method applied a phenomenological psychopathology analysis to the clinical material. We first compare Binswanger’s conception of mania with psychopathic functioning. Patients’ behavior is similar but there is a difference related to the dialectic between the ego and the alter ego. A patient with mania has a fundamental crisis of the ego, which a psychopath does not have. A second finding of our investigations concerns emotions and the adaptive dimension of the psychopathic disorder. An epistemological discussion of the concept of emotions reveals that psychopaths are competent in the management of emotional stimuli, which confers a psychological advantage upon them.

Oxford Handbook of Phenomenological Psychopathology, 2019

Mad, Bad or Adapted? Psychopathology of Psychopaths present a holistic conception of psychopathy inspired by phenomenological psychopathology and compares it with the mainstream nosographic diagnosis (Schneider, Cleckley, Hare and Cooke). The chapter illustrates how a structural-phenomenological approach enhances the investigation of psychopathy. An epistemological discussion of the concept of emotions reveals that psychopaths are competent at managing emotional stimuli, which bestows a psychological advantage upon them. More specifically, a reflection enlightened by the contributions of phenomenological philosophy on empathy and sympathy clarifies the presentation of “psychopathic being-in-the-world”. Starting with the tension between clinical practice and criticism of the dominant diagnostic scales, we consider the “essential characteristics” of the psychopathic disorder to be: reification of the alter ego without an ego-related disorder, emotional coldness as it provides adaptive benefits, and empathic skills without sympathy.

Conceptualizing Psychopathy: An overview, 2020

Psychopathy is the most controversial and elusive construct of our times. Although the concept has been around for over 100 years, our understanding of psychopathy remains relatively opaque as there appears to be little consensus in relation to the definition and clinical characteristics of the disorder. The etiology of psychopathy remains largely unknown, whereas psychological treatments for psychopathic patients are marked by therapeutic pessimism, as these patients appear immune to any therapeutic intervention. Given the confusion and heterogeneity of psychopathy, the aim of this paper is to provide an overview of the conceptualisations of psychopathy, starting from the early historical forerunners to the most recent formulations of the disorder

Philosophy, Psychiatry, & Psychology, 2013