These people live among us. They always have been and they always will. We need to understand them for our own well-being, and that of our loved ones.
Psychopathy has always been part of human society; that is evident from its ubiquity in history’s myths and literature.19 Greek and Roman mythology is strewn with psychopaths, Medea being the most obvious.20 Psychopaths populate the Bible, at least the Old Testament, perhaps beginning with Cain. Psychopaths have appeared in a steady stream of literature from all cultures since humans first put pen to paper: from King Shahyar in The Book of One Thousand and One Nights;21 to the psychopaths in Shakespeare, including Richard III and, perhaps most chillingly, Aaron the Moor in Titus Andronicus; to the villain Ximen Qing in the 17th century Chinese epic Jin Ping Mei, The Golden Vase.22 More recent sightings in film and literature include Macheath, from Berthold Brecht’s Three Penny Opera, Alex DeLarge in Anthony Burgess’ A Clockwork Orange, and Hannibal Lecter in Silence of the Lambs.23
No cultures, or stations, are immune. One of the modern fathers of the clinical study of psychopathy, Hervey Cleckley, famously opined that the Athenian general Alcibiades was probably a psychopath.24 And of course there was the Roman emperor Caligula. But psychopaths much more typically come from the ranks of the ordinary. Cleckley wrote extensively about ordinary patients he classified as having severe forms of psychopathy and whom he opined were almost all “plainly unsuited for life in any community; some are as thoroughly incapacitated, in my opinion, as most patients with unmistakable schizophrenic psychosis.”25 But he also examined patients who were highly functioning businessmen—men of the world as he put it—scientists, physicians and even psychiatrists. These people were able to navigate the demands of modern society, despite having the same clinical constellations as their less-functioning brethren, including grandiosity, impulsivity, remorselessness and shallow affect. These functioning psychopaths have become the objects of much recent attention.26The Criminal Psychopath
We are normally more concerned about criminal psychopaths than about high functioning psychopaths. But if we are smart, we will keep our eyes open for antisocial personalities at all levels of functioning.
Psychopathy is a constellation of psychological symptoms that typically emerges early in childhood and affects all aspects of a sufferer’s life including relationships with family, friends, work, and school. The symptoms of psychopathy include shallow affect, lack of empathy, guilt and remorse, irresponsibility, and impulsivity (see Table 1 for a complete list of psychopathic symptoms). The best current estimate is that just less than 1% of all noninstitutionalized males age 18 and over are psychopaths.1 This translates to approximately 1,150,000 adult males who would meet the criteria for psychopathy in the United States today.2 And of the approximately 6,720,000 adult males that are in prison, jail, parole, or probation,3 16%, or 1,075,000, are psychopaths.4 Thus, approximately 93% of adult male psychopaths in the United States are in prison, jail, parole, or probation. __ Source
According to the review article linked above, there are about 1 million psychopaths in the US who are incarcerated, and about 1 million more psychopaths in the US who are not currently incarcerated. Of the 1 million psychopaths walking free, an unknown number are able to function well enough to climb their way up the socioeconomic ladder into medium and high levels of responsibility. The legal profession (including judges and legislators), for example, is likely to host a significant number of free-breathing psychopaths. The corporate media and academia likewise are probable places to find high functioning psychopaths. In fact, any profession where speech and behavior are relatively unchecked by objective truth-checking and careful self-policing will probably be a safe refuge for high functioning psychopaths.
Cluster B Personality Disorders
Cluster B personality disorders include the antisocial personality disorder (psychopathy and sociopathy), borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder. Source
There is some hope from therapy for those who fall into the categories of borderline personality disorder and histrionic personality disorder. For those with narcissistic personality disorder, the person feels no need to change in any appreciable way.
Narcissistic personality disorder, thought to affect anywhere from 1 to 6 percent of the population, is characterized by grandiosity; a need for excessive admiration; a lack of empathy; and manipulative, self-centered, or demanding behavior. Someone with NPD can cause significant distress for anyone who associates with them.PT
And for those with antisocial personality disorder (psychopathy and sociopathy) there is more danger of the therapist being adversely affected by the therapy than for the disordered personality being helped by the therapy.
Psychopathy comes about because of both genetic and environmental factors. We know that there are racial differences in rates of violent crime. Using violent crime as a rough proxy for psychopathy, one might be tempted to say that psychopathy is more common in particular racial groups than others. But the direct evidence for such a claim is limited.
For the sake of accuracy, psychopathy is best diagnosed by the specialized tools that have been developed for that purpose. Of course, in the case of a long running serial killer, you are pretty safe in applying that label to the person. But for the destructive psychopathic attorney, judge, politician, professor, or media personality, it is best to use the tool for a diagnosis if you can get honest replies from them. Remember: Narcissists are more common in those professions than psychopaths. So save your accusations of psychopathy for those where the diagnosis is demonstrably applicable.
Cluster B personalities cause a lot of trouble for society in general and for families and communities in particular. These people generally have very little insight into themselves, and are very unlikely to change for the better, once these personality traits become entrenched. But for those who must deal with them, information can be invaluable in making the decisions that have to be made.