Suffering Souls

There was a fascinating article about psychopaths by John Seabrook last month in The New Yorker:

At thirty-eight, Kiehl is one of the world’s leading younger investigators in psychopathy, the condition of moral emptiness that affects between fifteen to twenty-five per cent of the North American prison population, and is believed by some psychologists to exist in one per cent of the general adult male population. (Female psychopaths are thought to be much rarer.) Psychopaths don’t exhibit the manias, hysterias, and neuroses that are present in other types of mental illness. Their main defect, what psychologists call “severe emotional detachment”—a total lack of empathy and remorse—is concealed, and harder to describe than the symptoms of schizophrenia or bipolar disorder. This absence of easily readable signs has led to debate among mental-health practitioners about what qualifies as psychopathy and how to diagnose it. Psychopathy isn’t identified as a disorder in the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association’s canon; instead, a more general term, “antisocial personality disorder,” known as A.P.D., covers the condition.

There is also little consensus among researchers about what causes psychopathy. Considerable evidence, including several large-scale studies of twins, points toward a genetic component. Yet psychopaths are more likely to come from neglectful families than from loving, nurturing ones. Psychopathy could be dimensional, like high blood pressure, or it might be categorical, like leukemia. Researchers argue over whether tests used to measure it should focus on behavior or attempt to incorporate personality traits—like deceitfulness, glibness, and lack of remorse—as well. The only point on which everyone agrees is that psychopathy is extremely difficult to treat. And for some researchers the word “psychopath” has been tainted by its long and seamy relationship with criminality and popular culture, which began with true-crime pulps and continues today in TV shows like CBS’s “Criminal Minds” and in the work of authors like Thomas Harris and Patricia Cornwell. The word is so loaded with baleful connotations that it tends to empurple any surrounding prose.

Kiehl is frustrated by the lack of respect shown to psychopathy by the mental-health establishment. “Think about it,” he told me. “Crime is a trillion-dollar-a-year problem. The average psychopath will be convicted of four violent crimes by the age of forty. And yet hardly anyone is funding research into the science. Schizophrenia, which causes much less crime, has a hundred times more research money devoted to it.” I asked why, and Kiehl said, “Because schizophrenics are seen as victims, and psychopaths are seen as predators. The former we feel empathy for, the latter we lock up.”