AMERICAN JOURNAL OF FORENSIC PSYCHIATRY, VOLUME 27, ISSUE 4, 2006 / 1

THE GENERAL THEORY OF PSYCHOPATHY

Dr. Z. Bobich

According to this theory, psychopathy is defined as a disorder of personality that is characterized by lack or severe underdevelopment of super-ego, any attachment and any inhibiting mechanisms that would deter a normal person from rendering any antisocial, immoral or wrong behavior. The theory has proven its ability to accommodate all other specific models and theories of psychopathy. According to the DMS-IV or ICD-10, psychopathy does not exist, as they only recognize antisocial personality disorder and dissocial personality disorder. Nevertheless, we all know that it exists in society. The first described psychopaths were Samson (1) and Alcibiades (2). In most recent history the development of psychopathology brought to the surface Pinels case of a peasant who, in an outburst of rage threw a woman down a well. Pinel called it manie sans delire (3). In 1835 Rush described individuals constitutionally deficient in moral faculties (4). In the same year Prichard (5) coined a label of moral insanity, which he believed was a result of organic or constitutional factors with poor prognosis for change. The term further evolved as in 1891 Koch (6) referred to psychopathic inferiority and later on, Krapelin (7) and Schneider (8) used the term psychopathic personality. A new term, sociopath was introduced by Partridge (9) in 1930 and was substituted by antisocial personality disorder by DSM-II (10) in 1968. This term is still in use (professionals that follow the European tradition rather use the term dissocial personality disorder), although the meaning has been changed mainly for political reasons. The emphasis was on social deviancy (meaning behavior) and personality was ignored. It is interesting because Robins and Reiger (11) determined that antisocial personality disorder, as defined by the DSM-III, had an average duration of 19 years from first to last symptom. It is likely that the reason for that is in the fact that people with antisocial personality disorder became too old to maintain a
Copyright 2006 American Journal of Forensic Psychiatry, Volume 27, Issue 4. The Journal is a publication of the American College of Forensic Psychiatry, P.O. Box 5870, Balboa Island, California 92662.

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criminal lifestyle. However, it is less likely that the personality has been changed. Cleckley (12) identified 16 characteristic features, which were later used by Hare (13) who added a few more to form his PCL-R. He distinguished two factors reflecting hostile narcissism and criminal lifestyle. This concept is heavily saturated with behavior and it is closely linked with DSM-IV and ICD-10, mainly for political reasons. It works well for convicted criminals imprisoned in North America and Canada. Unfortunately, it does not recognize other types of psychopaths, such as those who have never engaged in criminal behavior, also known as white collar psychopaths and sadists. (Sadism mysteriously disappeared from DSM-IV, although it existed in DSM-III). Another main stream of thought is orientated towards personality traits rather than behavior. Karpman (14) distinguished primary from secondary psychopathy. Apart from primary and secondary psychopaths there are also distempered and charismatic types that are recognized in current literature. Further on, Millon (15) described 10 variants of psychopathy, each of which is found in personality disorders classified in DSM-IV or ICD-10. One of the most recent attempts was one of Lilienfeld (16) who focused his exploration of psychopathy on personality traits, rather than behaviors. He distinguished 8 psychopathy traits. In summary, the present situation is that we have two main approaches focused on behavior and personality, a number of various types of psychopathy based on different and sometimes poorly defined criteria, several specific models with or without theoretical background and a lot of politically motivated concepts.
THE PURPOSE

Existing models mainly look at some specific characteristic, behaviors or traits of psychopathy, hence they are not complete. Furthermore, they often focus on a particular population, such as violent individuals, or incarcerated criminals, lacking universality of their applications. This fragmentation led to a need to unify the existing knowledge about psychopathy and elevate it to a higher level determined by its universality. The purpose of this work is to summarize the last 200 years of work on psychopathy, embrace the main models, analyze them, extract what they

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have in common, give a theoretical basis and finally, a proper definition of psychopathy as a unique psychopathological entity. If successful, all present models will be able to fit into this general theory of psychopathy.
THE METHOD

Choosing the methods for this work was determined by the problem. The methods used are 25 centuries old and came from Aristotelian logic, which has been neglected on behalf of modern and sophisticated mathematicstatistical methodology. The major problem with that methodology is that it gives back what was put in (the famous GIGO principle). Instead, we used the old logic method of forming notions that worked well and never failed over the last two and a half millennium. In forming notions we used item by item and analyzed them. The second step was synthesis and the third and final step was generalization. If properly conducted, the final product of this method is a notion (in this case, psychopathy). The second method used also came from logic and it is definition. A notion is not complete without a logical definition. Definition is formed by genus proximus and differentia specifica. It means that we first have to establish the nearest genus (a class of things containing a number of subordinate classes [called species] with certain common attributes) and then, a specific difference, (a class of things subordinate to a genus and containing individuals sharing an attribute or attributes absent from other members of the genus and called by a common name; the essential quality or specific properties of a thing.)
THE RESULTS

A body of literature was searched and the main characteristics, traits, behaviors, items and descriptions of psychopathy and/or antisocial personality disorder were extracted and an item pool of 225 items was formed. The list is not completed and probably never will be. However, it contains the most common and most significant items used in various models to define psychopathy. After using the above described methodology, it became clear that the items reflected three main spheres of human functioning, that is, cognitive, affective and behavioral. Further analysis of each sphere revealed that the

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common denominator of cognitive sphere was lack (or severe underdevelopment) of super-ego; lack of any relevance or importance of rights and wrongs in the psychopaths minds. Affective sphere is characterized by lack (or severe underdevelopment) of any attachment. They feel no sadness or fear because psychopaths are prisoners of the present and sadness and fear/anxiety are linked with the past and future respectively. The third, behavioral sphere is determined by lack (or severe underdevelopment) of any inhibiting mechanisms that would deter a normal person from rendering any antisocial or immoral or wrong behavior. The table below summarizes the analysis and synthesis of the items from the item pool. At the bottom of each column is the final generalization which is, lack of super-ego (cognitive), lack of attachment (affective) and lack of inhibition (behavioral).
COGNITIVE No moral principles AFFECTIVE Lack of remorse and shame Hates animals Happy with himself No attachment to anyone or anything No feelings for others, only for himself Feels no mercy Hates the weak No fear of punishment Admires himself No fear of abandonment No anxiety No fear of future Dislikes uncertainty BEHAVIORAL Aggressive Tries to fill in his emotional emptiness by material objects or status Charismatic Ability to disguise his real intentions Politeness as a faade Shows no mercy Smooth operator Constant lying Uses all means to achieve what he wants Unstoppable in his intentions Has to be in absolute control Demonstrates his status Gathers material goods that have no meaning apart from showing off his

Sees others as enemies The goal justifies the means Semantic aphasia Truly believes that he is above others Entitlement Grandiosity Status is more important than merits Form is more important than content Expects perfection from others Intolerant to others mistakes Attacks a person rather than his behavior Assumptions

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power or status Truth by authority Black and white thinking Enthymeme Genetic fallacy Gets personal Hypocrisy Has temper tantrums Jealous Envious No sentiment Loss has no meaning Does not feel any Friendship Love Affection Sympathy Achievement orientated Aggressive Invades Intrudes Imposes Uses force to achieve what he wants

Defenses: Compensation Projection Rationalization Isolation Displacement Denial Reversal Splitting Acting out Power hungry Strong destroy the weak Always puts himself first Cant stand defeat Bad loser Victory has the highest priority Never admits guilt

Ruthless

Independence is an imperative for him

Respects only himself No respect or appreciation for others No regard for the rights or needs of others Sees others only as objects Dehumanization of others Others are his feeding ground Others are there to be used and to serve his purpose Feels emotionally empty Low IQ and criminal psychopaths are often covered with tattoos Always wants to show off his power or status

Thrives under pressure or when cornered Feels thrilled after escaping a great danger Reckless for others and his own safety Careless Over-controlling

Cant be trusted Cant trust

Never admits responsibility Never honors financial obligations Realistic

Unreliable No differentiation in victims. Capable of using all means from persuasion to murder to achieve what he wants Exhibitionistic

Understands others weaknesses and takes

Low tolerance threshold

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advantage of it Power gives the right Cant stand frustration Treats others as inanimate objects to be manipulated and used Abandons others and forgets them when something or someone more interesting comes along Determined to go to the end Takes any risk regardless of consequences Expansive Out of bounds Violent with no hesitation if other means dont work Often rigidly oppositional Arrogant Demands rather than asks Once he starts, he will rigidly follow his way regardless of inevitability of being punished Wants to be praised or flattered even following his worst behavior Argumentative Defiant Competitive Combative Physically aggressive Cruel to others, especially to the weak Cheats in order to win Violent in order to win Plays dirty in order to win

Philanthropy is a false pretension

Stubborn

Denies any moral value Tyrannical righteousness Wants unlimited freedom Superficial charm Freedom is to do what he wants Freedom is a privilege of the strong Only goal is to get what he wants Resistant to any change No moral values No integrity

Self-important Cant accept or take criticism Always wants to win Apathetic to others Not neurotic Easily upset Easily irritated Vulnerable to narcissistic injury Narcissistic Seeks excitement

No principles in life Manipulative Morally immature Pathological lying Irresponsibility Understands the rules but does not accept nor obey them Poor judgment Lack of any long-term plans Callous

No close friends Easily bored No genuine feelings Angry Lack of fear Lack of sadness His depression is always a result of his self-pity Unable to express his feelings Often does not know what feelings are

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Egocentricity Does not forgive nor forget He is always right Always wants to be in control Past has no meaning Disinterested in the future Prisoner of the present Rarely delusional Sometimes shows loyalty to his subculture, but only when it serves his purposes Believes he is superior

Recognizes only anger, power and strength Sexual relationships impersonal Cant distinguish love from lust Unable to establish intimacy with anyone Incomplete range of emotions Does not trust anyone Confident Insincere Good actor

Critical of others Likes to put others down Belittles others Dominates others Likes humiliating others Unconstructive expenditure of energy Socially irresponsible Risk taking No life plans

Poor sense of humor Practical Better in concrete than in abstract thinking Resents any authority Promises something for nothing Rarely keeps his promises (only when it serves his purpose) Rigid Intolerant

Deceives people into believing that he is Likeable Charming Intelligent Alert Impressive Confidence-inspiring Successful Grooms people to believe him before he destroys or at least abuses them No feelings for others apart from scorn

Cant resist temptation

Geographically mobile

Cruel to animals Doesnt get on well with neighbors Likes to hurt others Threatens Bullies Rebellious without cause Poor financial management Possible addiction Does not keep promises Confides in no one

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NO SUPEREGO

NO ATTACHMENT

NO INHIBITION

Finally, here is our definition of psychopathy that came as the result of the above work: Psychopathy is a disorder of personality that is characterized by lack or severe underdevelopment of super-ego, any attachment and any inhibiting mechanisms that would deter a normal or average person from rendering any antisocial, immoral or wrong behavior. There is no need to emphasize that to diagnose someone with psychopathy, one has to satisfy all three criteria.
TESTING THE THEORY

To test the General Theory of Psychopathy we used PCL-R (Psychopathy Checklist Revised), which is currently the most used and researched model in current forensic practice. The model was developed by Dr. R. Hare in continuation of the original work of H. Cleckley. The model works well for a specific population that is, criminals, usually violent, who were caught, convicted and imprisoned. It contains 20 items which are listed below. They are classified using the criteria of the General Theory of Psychopathy.

Glibness/superficial charm Grandiose sense of selfworth Pathological lying Conning/ Manipulative Lack of realistic, long-term goals Failure to accept responsibility for own actions Needs for stimulation/ Proneness to boredom Irresponsibility NO SUPEREGO

Lack of remorse or guilt Shallow affect Callous/Lack of empathy Many short term marital relationships

Parasitic lifestyle Poor behavioral controls Promiscuous sexual behavior Early behavioral problems Impulsivity Juvenile delinquency

Revocation of conditional release Criminal versatility NO ATTACHMENT NO INHIBITION

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As one can see, Hares model perfectly fits into the General Theory of Psychopathy. The difference is that Hares model is specific as it is focused exclusively on the criminal population (those on the wrong side of the law) and hence, missing so-called white collar psychopaths.
REFERENCES

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11. 12. 13. 14.

15. 16.

The Old Testament Plato (Rowe CJ, Ed.): Symposium (Classical Texts). Aris and Phillips, 1998 Pinel P: A Treatise of Insanity (Translation by Davis DD.) New York, Published under the auspices of the Library of the New York Academy of Medicine by Hafner Publishing Company, 1962 (Original work published in 1801) Rush B: Medical Inquiries and Observations Upon the Disease of the Mind (5th ed.). Philadelphia, Grigg and Elliott, 1835 Prichard JC: A Treatise on Insanity and Other Disorders Affecting the Mind. London: Sherwood, Gilbert, and Piper, 1835 Koch JLA: Die Psychopathischen Minderwertigkeiten. Ravensburg, Germany, Maier, 1891 Kraepelin E: Clinical Psychiatry: A Textbook for Students and Physicians (Abstracted and adapted by A. R. Diefendorf from the 7th German edition of Lehrbuch der Psychiatrie). New York, Macmillan, 1923 (Original work published in 1907) Schneider K: Psychopathic Personalities. London, Cassell, 1923 Partridge GE: Current conceptions of psychopathic personality: I. The concept of psychopathic personality. American Journal of Psychiatry 1930; 10:53-99 American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 2nd Edition. Washington DC, American Psychiatric Association, 1968 Robins L, Reiger D: Psychiatric Disorders in America. New York, Free Press, 1991 Cleckley H: The Mask of Sanity. St. Louis, MO, Mosby, 1941 Hare R: Hare PCL-R Technical Manual, 2nd Edition. Toronto, Multi-Health Systems, 2005 Karpman B: Perversions as neuroses (the paraphiliac neuroses): their relation to psychopathy and criminality. Journal of Criminal Psychopathology 1941; 3:180199 Millon T: Psychopathy Antisocial, Criminal and Violent Behavior. New York London, The Guilford Press, 2003 Lilienfeld SO, Widows MR.: PPI-R Psychopathic Personality Inventory Revised Professional Manual. Lutz, FL, Psychological Assessment Resources, 2005

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ABOUT THE AUTHOR

Born in 1954, graduated psychology in 1979, postgraduate study in Social Psychiatry in 1980, then two masters degrees in 1981 (Medical Sciences) and 1985 (Clinical Psychology), doctorate in Medical Sciences in 1989 and Statement of Equivalence in 1996. Lives and works in England in the field of clinical and forensic psychology. Author of 6 psychometric tests, 17 scientific and professional articles and a book Recognise your Enemy (2000). Biography published in Marquis' "Who's Who in the World", "Who's Who in Medicine and Healthcare", "Who's Who in Science and Engineering", The Barons 500 - Leaders for the New Century, The Barons 500 Europe and 500 Great Minds in the Early 21 st Century. Founder and Director of Psychology Consultants Ltd. Source : http: //www.neurodynamic.info