Although it happens that sometimes he gets agitated, has fits of anger, gets excited, bursts into tears or opens up in deep speeches spiced with pained words about his misfortunes and follies, observing him carefully one realizes that what we are witnessing is more a readiness of expression than a force of feeling “.
(Hervey Cleckley, The Mask of Sanity )
Psychopathy: symptoms and characteristics
The disorder Psychopath ( psychopathy ) is characterized by an enduring pattern of antisocial behaviors that begin in childhood. It is the first historically recognized personality disorder in psychiatry and has a long clinical tradition. It is characterized by a series of interpersonal, affective and behavioral factors listed below:
- Loquacity / superficial charm: the psychopath is often a funny and pleasant conversationalist, able to tell unlikely but convincing stories, which put him in a good light in the eyes of others;
- Grandiose sense of self: psychopathy is characterized by a high opinion of one’s worth and characteristics;
- Need for stimuli / propensity to boredom: the psychopath gets bored quickly and tends to seek behavioral or emotional re-activation by engaging in risky behaviors;
- Pathologicallying: usually has a remarkable readiness and ability to lie;
- Manipulation: can make use of fraud to cheat, deceive or manipulate others, in order to achieve a personal purpose perceived as advantageous;
- Absence of remorse / sense of guilt: psychopathy can manifest itself as an absence of concern for the negative consequences of one’s actions;
- Superficial affectivity: emotions are often theatrical, superficial and short-lived;
- Behavioral Control Deficit: The psychopath may be angry or irritable, as well as responding to frustration with verbally aggressive behavior or violent conduct;
- Impulsivity: A lack of reflection, planning and premeditation may be present in psychopathy.
Neurobiological features of psychopathy
Neurobiological models of psychopathy have focused on the peculiar functioning of limbic and paralimbic structures, in particular the amygdala and ventromedial prefrontal cortex, trying to shed light on the association between dysfunctions in these areas and lack / lack of empathy and regulation of behavior.
There are mainly two theses that have attempted to explain why people with psychopathy do not normally experience empathy and guilt: (a) the empathic deficit hypothesis (Blair 1995) and (b) that of lack of fearfulness (propensity to fear) (Hare 1970; Kochanska 1997; Lykken 1995; Patrick 1994).
According to the hypothesis of the “empathic deficit” an anomaly in the functioning of the amygdala would be found which would make it difficult / absent to recognize the emotions of others such as anxiety and sadness . The second thesis argues that at the base of the disorder there is an alteration of the amygdala which would manifest itself in poor fearfulness (low reactivity to noxious or threatening stimuli). It would imply insufficient sensitivity to punishment and, consequently, a limited importance attributed to moral norms.
Emotional characteristics of psychopathy
The psychopaths show difficulties in processing emotional information and responding empathically to others. This deficit could be at the basis of the success these individuals often have in manipulating and deceiving other people, resulting in convincing.
The absence of emotional reciprocity and empathy, or the reduction in intensity with which emotions are experienced and represented, could explain the peculiar capacity of persuasion that characterizes such individuals: lacking empathy, in fact, psychopathic people would be better able to represent their victim as “an object to be used”, managing not to feel remorse or guilt for the consequences of their actions.
Cognitive features of psychopathy
The basic patterns of self, others and the world of psychopaths seem to be characterized by rigidity and inflexibility: the psychopath sees himself as strong and autonomous, while others as weak and vulnerable to exploitation (prey). There is typically a bias where the malicious intentions of others are overestimated. The psychopath will therefore tend to pay maximum attention, minimizing the risk of victimization and becoming an aggressor himself.
The scientific literature has explored the capacities of moral judgment in psychopathy, trying to understand whether or not the person affected by this problem is able to distinguish “what is right” from “what is morally wrong”.
The results of the research have highlighted how people suffering from psychopathy mainly exhibit utilitarian personal moral judgments: this would explain the tendency to violate rules and social norms in order to obtain advantages for themselves. According to this perspective, the psychopath would generally be hyper-focused on the goal and, consequently, would not be able to take into due account the “moral” costs of his own conduct.
Role of empathy in psychopathy
Empathy normally exerts an inhibiting effect on aggressive behavior since it represents a shared affective experience between two human beings. According to Feshbach and Feshbach (1969), individuals capable of accurately assuming the other’s perspective are more inclined to engage in prosocial actions rather than aggressive conduct.
The difficulty observed in psychopathic subjects to represent themselves and “feel” the emotional experience of the other has been interpreted by other scholars as the consequence of an active and conscious distraction from the victim’s gaze, which the antisocial person would voluntarily put in place in order to inhibit the natural activation of prosocial feelings and therefore being able to maintain a cold and sufficiently detached attitude.
In fact, the ability to grasp the fear or sadness of another is not necessarily accompanied by a positive attitude: the empathic resonance of the suffering of others can even be at the service of “immoral” desires. It follows that, rather than having a deficit of empathy, psychopaths may have “antisocial purposes” and not give so much weight to the representation of the suffering of the other, empathic or intellectual, rather than to the representation of their own personal purpose (Mancini, Capo and Colle, 2009).
Evolutionary paths of the psychopathic personality
The developmental history of psychopaths is generally characterized by dysfunctional parenting experiences , as described by Patterson and collaborators (1991; 1998). According to the “theory of coercion” psychopathic behavior would be learned within the family and then generalized to other contexts and situations. The poorly cooperative behaviors of children would be a consequence of coercive interactions between parents and children.
Some examples of dysfunctional parenting are: inconsistent or, conversely, excessively severe discipline; low supervision and monitoring; insufficient expression of affection; high number of negative verbalizations and high expressed emotionality (Cornah et al. 2003; Portier and Day 2007).
Research by Patterson and colleagues (1991) shows that the parents of subjects with psychopaths rarely exercise a significant and contingent punishment for aggressive and uncooperative behavior they intend to reduce, and they also do not provide instructions to their child through aversive stimuli. If they do, this is carried out on the emotional wave of the moment (angry attitude, exaggeration of the punishment then retracted, incoherence in managing contingencies, etc.). Furthermore, from the longitudinal studies carried out by Patterson and collaborators (1998) it has been highlighted that the coercive interactions just described between parents and children predict aggressive relationships with peers and affiliation with deviant groups in adolescence.
Implications for the treatment of psychopathy
From the point of view of prognosis and treatment, it has been observed (Robbins, Tipp, Przybeck, 1991) that antisocial and psychopathic tendencies tend to decrease naturally over the years, especially after the age of forty-fifty (Black, 1999) and that criminal actions or, at least, violent crimes, usually tend to recede. The behavioral components of psychopathy are usually more likely to benefit from treatment than are the personality traits typical of the disorder (Dazzi and Madeddu, 2009).
The ability to feel empathy may be a crucial element for a more favorable prognosis (Streeck-Fisher, 1998) in the treatment of psychopathy . We have seen how the low sense of guilt of psychopathic subjects and the low propensity to respect social and ethical norms can also be explained as the result of particular evolutionary experiences that have predisposed the subject to the creation and maintenance of specific purposes and beliefs such as:
- propensity to perceive others as hostile, unfair and rejecting;
- experience of authority as unfair and inadequate to the role (excessively controlling or lax and disinterested);
- investment in dominance and aversion to heteronomy;
- experiences of non-belonging and diversity with respect to the general group of peers.
Evidently, embracing the thesis of the “structural deficit” of psychopathy or one based on aims and beliefs implies numerous differences on the clinical level. Considering the low sense of guilt as the effect of specific experiences with authority and with peers, rather than as the expression of a cognitive deficit, it implies, in fact, preferring to rehabilitative interventions aimed at recovering deficient mental functions (training focused on theory of mind and empathy), specific procedures aimed at:
- induce the subject to understand the nature and reasons of his own behavior through a review of his own evolutionary history;
- favor more positive experiences of authority (highlighting, for example, its protective and supervisory function with respect to mutual rights and duties);
- manage the action-reaction contingencies in order to make the consequences of the action certain and predictable both in reference to the “punishments” (certainty of the penalty) and to the “gains” deserved;
- reduce hostile attributive bias;
- encourage the construction of a social role (attitudes, skills, etc.) useful for fostering belonging and cooperation;
- to experience the pleasure and functionality of affiliation and prosociality;
- connect personal worth and good image with behavior ethically
