Psychopathy

It is my hope that through the lens of the wisdom of the Church’s tradition, I am able to reveal the deeper reality that remains hidden behind the label of psychopathy. By its very nature, an exploration into the world of the psychopath seeks to answer the perennial question that has perplexed mankind—why do people commit horrendous acts of evil? A central motivating factor for this essay is the number of books which have been published in recent years which tend to emphasize two perspectives on the disorder. The first group of books predominantly argue the case for the biological basis of psychopathy. The second group of books identify the psychopathic traits that are beneficial to achieving success—especially in business, where the ability to be ruthless and manipulative are traits that can help achieve success. This disturbing trend tends to: (1) reduce responsibility for people’s behavior through attributing psychopathy to biological causes, and (2) as a consequence of focusing on the “positive” traits of psychopathy, it minimizes the seriousness of the disorder in the light of its eternal consequences.¹

What is Psychopathy?
Psychopathy is understood as a disorder where someone displays a callous and ruthless attitude towards others. Their lack of empathy and manipulative behaviour means they significantly impact the lives of the people they affect. The prevalence of psychopathy is estimated as being around 0.5 to 1% of the population.²

There is growing evidence which proves scientifically that psychopaths are wired differently when compared to people who do not have psychopathy. Within the literature on psychopathy, sometimes people are also referred to as sociopaths. Someone with sociopathy is understood as having developed their sociopathic traits through the influence of nurture, rather than nature. In this essay, I want to focus on psychopathy, which is understood as having a biological basis. It has a more comprehensive evidence base, and a clinically valid diagnostic tool, the psychopathy checklist revised (PCL-R).

Psychopathy is recognised as being a personality disorder where the person evidences dysfunctional traits that are consistently displayed in different circumstances over a significant period of time. In other words, they are global and pervasive. The key difference between psychopathy and psychosis is that a person with psychopathy can distinguish reality from that which is not real, whereas a person suffering a psychotic episode cannot.

The famous psychologist, Robert Hare, defined the key symptoms of psychopathy across the emotional, interpersonal, and behavioral dimensions of the human person. He developed the PSL-R, which is a scientifically valid tool that reliably identifies people who meet the threshold for a diagnosis of psychopathy. While some people may evidence some of the traits listed below, they will not meet the threshold for a diagnosis of psychopathy if they do not score 32 or more out of a maximum score of 40. In other words, significant evidence of a majority of the traits which form a global and pervasive pattern in the person’s life.³

A key aim of this essay is to not only identify what is different in the psychopath, i.e., a person who meets the threshold for a diagnosis of psychopathy, but to explore what is different about the individual traits the psychopath exhibits. It is highly likely there is a cohort of people who display psychopathic traits, but would not meet the threshold for a formal diagnosis.

The thing is, everyone falls somewhere on the psychopathy continuum. The average person scores about a 4, but there are plenty who rank in the teens and 20s—not high enough to receive an official diagnosis, yet possessing significant (and often noticeable) psychopathic tendencies—the bullying boss, the drifter, the irresponsible guy who is always milking the generosity of friends and lovers.⁴

The twenty traits that are evaluated in the PCL-R fall into three categories: emotional, interpersonal, and behavioral. The emotional traits are listed as: a lack of remorse or guilt, shallow affect (superficial emotional responsiveness), and callousness, i.e., lack of empathy. The interpersonal traits are glib and superficial charm, grandiose (exaggeratedly high) estimation of self, need for stimulation, pathological lying and cunning, and being manipulative. The behavioral traits are parasitic lifestyle, poor behavioral controls, sexual promiscuity, early behavior problems, lack of realistic, long-term goals, impulsivity, irresponsibility, failure to accept responsibility for one’s own actions, many short-term marital relationships, juvenile delinquency, revocation of conditional release, and criminal versatility.

Nature or Nurture?
As science and technology have advanced, we are able to undertake scans that increase our understanding of the brain and other organs—more than has been possible at any other time in history. The growing evidence for the biological basis for psychopathy has led to a number of recent publications which lay emphasis on its biological causes. The implication this has is very significant. If someone is born with psychopathy, how much responsibility should they be expected to take for their callous and manipulative behavior? If they are born with cognitive and emotional deficits, this would explain why they are unable to experience empathy; so then is it any wonder that they are completely incapable of understanding the impact of their behavior on other people. But what about nurture? Surely people who are born into families that are highly dysfunctional, with parents who either have psychopathy, or exhibit psychopathic traits, are destined to become psychopaths? This is not the case. Research evaluating the effects of early family background on later criminality in psychopathic, and other criminals, found that among criminals who were not psychopaths, the quality of family background was strongly related to the age of onset and seriousness of early criminal activities. In sharp contrast, the quality of family life had absolutely no effect on the emergence of criminality in psychopaths.⁵

So that rules out nurture then. This means that psychopathy must have a biological basis and, therefore, all psychopaths are predisposed to developing psychopathy, regardless of whether they are brought up in a stable, or dysfunctional, family. If that is the case, how do we account for the fact that through the eyes of faith, we know that God desires, intensely, our salvation and sanctification, and that everyone born has the means for their salvation: “…he wants everyone to be saved and reach full knowledge of the truth” (1Tim 2: 4). God does not predestine anyone to the eternal loss of their soul. How do we then explain the apparent biological evidence for psychopathy?

The position I take on the “nature vs. nurture“ debate is that there must be an interaction between both which contributes, in some way, towards someone becoming a psychopath. However, I believe this contribution is not the determining factor. What sets the psychopath aside is that their behavior is contrary to our human nature. The perverted will, which seeks inordinate evil, makes a series of deliberate choices that leads to the distorted world view of the psychopath, where people become objects, and where their interior life becomes completely disfigured. I hope to show the reader that, ultimately, what makes a psychopath is both—the rejection of actual grace and the love of evil.

Brain Imaging in Psychopathy⁶

Psychopathy is generally viewed as having a biological basis. The use of functional magnetic resonance imaging (fMRI) techniques, which study mental health and disease, began in the 1990s. The field of psychopathy has seen a rapid growth in the use of neuroimaging to understand the condition.

Studies have concluded that psychopathy is the result of both structural, and functional, abnormalities in the Para limbic, and limbic, structures of the brain. These areas of the brain are critical for the development of social and emotional behaviors. This suggests that psychopathy has a developmental course

As I outlined in the beginning of this article, it is the disturbing trend of books written on psychopathy that tend towards either explicitly or implicitly, a deterministic stance. Few will proclaim out-rightly that the psychopath should not be held accountable for their actions. However, by emphasizing the biological basis for psychopathy, you implicitly negate the capacity of the human will to exercise free choice. The key point that is invariably overlooked is that the psychopath has the ability to act differently, but freely choses to act in a manipulative and deceitful manner. As described below, we should always be held responsible for performing an act only if it was possible for us not to have performed it.

We should be held responsible for performing an act only if it was possible for us not to have performed it. To be responsible, a person must have a genuine choice, in other words, he must have been able to have chosen differently than he did choose. We hold the criminal offender responsible, not simply because he does what he wants, but because he did not forbear from doing what he wanted when he could have.⁷

This is such a crucial issue. Are the evil actions of the psychopath predetermined by their biological make-up, or do they really have the capacity to choose differently? Ultimately, this is the age-old question that countless books, and research projects, have sought to answer.

The Effects of Sin on the Soul
Today’s secular world  in the main denies the existence of sin. The idea that sin scars and damages our soul is not, surprisingly, also denied. The Doctors and Saints of the Church, throughout the course of history, have shown how sin, in many different ways,  destroys the soul. The faculties of the soul are the intellect, memory, and will. Some of the mystics of the church have actually seen the full effects of sin in their visions. Blessed Anne Catherine Emmerich describes how she saw the wounds of the morally sick, and how they were far more offensive than bodily wounds.

The wounds of the morally sick were the most offensive, for their source is in the depths of the heart; exteriorly, they do not seem so hideous, though they are really far more horrible. Bodily wounds are not so deep, and they have a more healthful odor; but they who do not understand such things, think them the more frightful.⁸

The human soul is spiritual and, therefore, invisible. The question remains: How does the ugliness of an invisible and spiritual soul explain how the brain—which is physical and visible when scanned—show abnormality in structure and function? The faculties of the soul are the memory, intellect, and will. The brain is integral to the function of the soul’s faculties. The traditional view of the human person is that they are comprised of a body and a soul, which operate interdependently. We cannot live without a soul, and when we die, the soul leaves the body to be judged by God.

In Sacred Scripture, the term “soul” often refers to human “life”” or the entire human “person”. But “soul” also refers to the innermost aspect of man, that which is of greatest value in him, that by which he is most especially in God’s image: “soul” signifies the spiritual principle in man.⁹

The inner most aspect of a human, that the catechism refers to, is a person’s interior life. The soul is the home of their desires, thoughts, private emotions, as well as their intentions and personal beliefs. This invisible and hidden life is the cause of the visible behavior which we observe in others. It is this behavior which is observed, studied, and categorized within a scientific framework. In the case of the psychopath, these are the interpersonal and behavioral characteristics detailed previously. Until we acknowledge that the hidden personal life of each person cannot be measured scientifically, and observed in the same manner as someone’s visible behavior, then the full impact of our personal and inner life will never be more fully understood. The inner life of the human person is integral to its form, and is what distinguishes it from all other living creatures. As described by the Catechism, the soul is the form of the body:

The unity of soul and body is so profound that one has to consider the soul to be the “form” of the body, i.e., it is because of its spiritual soul that the body, made of matter, becomes a living, human body; spirit and matter, in man, are not two natures united, but rather their union forms a single nature.¹⁰

It is a possibility, that if we live a life which is entrenched in mortal or deadly sin, this will flow into the physical bodily domain. This is because of the profound unity that exists between the body and soul. Of course, this cannot be demonstrated scientifically, but when viewing the experimental evidence for the biological basis for psychopathy through the lens of faith, it is clear that sin ravages the soul and, therefore, it is possible that this will leave physical scars in the body, i.e., the brain.

It is accepted that the symptoms of depression are manifested in a physical manner in someone who suffers from depression. The physical tiredness, lethargy, and lack of sleep, are physical symptoms that manifest themselves along with the mental symptoms of depressed mood, feelings of hopelessness, irritability, and negative thinking. It is plausible, therefore, that a dysfunctional interior life will have a physical effect on the body. The implication for this is very significant as it contradicts the materialistic and deterministic view of human behavior. If the view is held that someone is biologically predisposed to behave in a psychopathic manner, then it is the physical and observable processes in the brain which are the primary cause of their behavior, not their hidden, dysfunctional, interior life.

Conscience and Guilt
Robert Hare’s famous book on psychopathy is called:  Without Conscience. The Catechism highlights how the echo of God’s voice, deep within our hearts, urges us to do what is good, and to avoid evil. The law within us, inscribed on our hearts, is not something of our own doing. It is this aspect of our consciences that our secular world, today, finds intolerable, and too uncomfortable to acknowledge. The din of everyday life, and the distractions of our technological age, do everything to try and drown out the voice of our Creator, which echoes in our hearts.

Deep within his conscience man discovers a law which he has not laid upon himself but which he must obey. Its voice, ever calling him to move and to do what is good and to avoid evil, sounds in his heart at the right moment… For man has in his heart a law inscribed by God… His conscience is man’s most secret core and his sanctuary. There he is alone with God whose voice echoes in his depths.¹¹

Within the Christian tradition, it is recognized that a person becomes more sensitive to the echo of God’s voice following their conversion. This is because the grace of their repentance, and the forgiveness of their sins, enables them to begin to hear and listen to God’s voice more attentively. The key determinant in being able to listen to God speaking in the depths of our heart is a purity of heart that is free from sin, and the attachment to sin. The tragedy is that if we remain outside the life of grace, we can become increasingly deaf to God’s voice, and so lose our moral sense, and lack discernment in what is right, and what is wrong. What distinguishes the psychopath, and the view that they are without a conscience, is that the voice of conscience is deafened under the weight of mortal and deadly sin. Because the conscience is not heard, this does not mean that it does not exist. While we may lack this ability to discern correctly, at a deeper level, we do not lose the ability to know that what we are doing is wrong, and that our actions are forbidden.

Though I lost my sense of the obligation which I lie under to abstain from acts of dishonesty, I should not in consequence lose my sense that such actions were an outrage offered to my moral nature. Again: though I lost my sense of their moral deformity, I should not therefore lose my sense that they were forbidden to me. Thus, conscience has both a critical and judicial office…: its testimony that there is a right and a wrong, and its sanction to that testimony conveyed in the feelings which attend on right or wrong conduct.¹²

If we accept the true nature of our conscience, then this sheds abundant light on the disorder of psychopathy. If God wills the salvation of every single person born, and provides the means for their salvation, then a very significant means is their conscience. It is clear that we never lose the light to know that what we are doing is wrong.

When we have done something wrong, guilt remains as long as we do not admit our fault, and are sincerely sorry for what we have done wrong. This is the biblical view. One of the key characteristics of the psychopath is a lack of guilt or remorse. The truth is that guilt remains in the soul, and poisons it through the venom of sin, which has not been repented. So, while on the surface the person may appear to have a lack of guilt, the reality is that the guilt associated with unrepentant crimes remains buried within the soul. The modern or secular understanding of guilt lacks the dimension of unrepentant sin. Hare’s “psychopathy checklist” effectively equates guilt with remorse by describing the psychopath as being someone who lacks remorse or guilt. To be without remorse is to be without regret. Sincere regret for having committed a crime is not to be sorry for oneself because of being caught, but to be sorry for the harm done to those affected. The objectification of persons by the psychopath means that this quality is absent. In the biblical world, to lack guilt for something that one has done is to have repented, and sought forgiveness from the person affected, as well as from God. This is, therefore, a positive attribute.

The Reality of Actual Grace
Without God’s grace, it is almost impossible to perceive that the troubles we experience in this world are His means of waking us up to discover the truth which has been hidden from our eyes. Our God wants to open our eyes to discover the primordial principle that will change our perception of life: that this world is temporary, and that our goal is not to be focused purely on this life and this world. As God, the Father told St. Catherine: “I am their goal.”

I send people troubles in this world so that they may know that their goal is not this life, and that these things (of the world) are imperfect and passing. I am their goal, and I want them to want me, and in this spirit they should accept such things. Now there are some, I tell you, who when they feel the pressure of trouble are prompted to remove the cloud from their eyes by their very suffering and by what they see must be the consequences of their sin.¹³

The outcome described by St. Catherine is the desired result. The suffering a person experiences enables them to be taken into a deeper level of reality where they themselves see clearly the full consequences of their actions. Everyone has, at one stage of their lives, the opportunity to experience the consequences of their sinful behavior. They may not be aware that it is sinful and harmful to themselves, and to their relationship with God, but they will be aware that they are responsible for the suffering they experience, and the negative impact it has on themselves, and others.

How many actual graces do we receive in our lifetime? How many experiences of suffering through troubles and difficulties do we experience in life? Many of them are minor, and some are major. We all receive countless graces communicated by God in this manner. They are graces communicated to us only, as no one else will experience the same trials and difficulties that we ourselves experience. Imagine rejecting all these graces. All the time, the truth about our behavior is reflected back to us. Not only that, think of rejecting all the sanctions of our conscience—our conscience is a powerful means where God communicates his grace to us. The passage below describes the many ways God tries to reach us.

Tell sinners that I am always waiting for them, that I listen intently to the beating of their heart… when will it beat for me? Write that I am speaking to them through their remorse of conscience, through their failures and sufferings, through thunderstorms, through the voice of the Church. And if they bring all My graces to naught, I begin to be angry with them, leaving them alone and giving them what they want.¹⁴

The last line of Jesus’ words to St. Faustina, in the passage above, makes chilling reading. We automatically and naturally think that God’s anger is expressed in the troubles and difficulties that we personally experience, as well as the natural disasters that afflict the world. To experience the anger of God is to lose his divine protection. It is to be left alone without his many graces calling us to wake up to the reality of our situation, and gradually to come closer to discovering how much he loves us.

Every person born into this life has two significant choices which they can take following the troubles they experience in this world: the choice to come closer to reality, or evade it. The suffering experienced will always be accompanied by a period of reflection on what has caused this suffering. In relation to the psychopath, it is possible to see that during this period of reflection, they develop a catalogue of excuses, which are, in reality, lies to evade the reality that confronts them. What distinguishes the psychopath from other people is their pathological lying. This will be experienced in the lies they tell other people as they manipulate them to achieve their own perverted ends. But significantly, it will also be the hidden lies they tell themselves. We are all called to reflect on our behavior—this quiet and hidden moment, which we all experience, can be one filled with genuine reflection where we come to see and accept the reality about our behavior, or, it can be one filled with turmoil, as the mind teems with a string of lies in an attempt to completely evade the truth about ourselves.

The Human Face of the Devil
In order to more fully understand the emotional and interpersonal characteristics of the psychopath, we have to understand more fully the role of the devil in our fallen world. Just to remind ourselves, the emotional traits are a lack of remorse or guilt, shallow affect (superficial emotional responsiveness), and callousness, i.e., lack of empathy. The interpersonal traits are glib and superficial charm, grandiose (exaggeratedly high) estimation of self, need for stimulation, pathological lying and cunning, and being manipulative. The overriding point I want to make is that the person suffering from psychopathy exhibits the qualities and characteristics of the devil. They, in effect, become the human face of the devil—significantly, and this cannot be emphasized enough—which is through their own free choice. This does not mean to say that the psychopath is possessed by the devil.

We are all subject to the ordinary action of the devil—the temptations which we all experience on a daily basis, whether we are conscious of them or not. The devil tempts us with what seems good, and the things of this world which appeal to our senses, and need for immediate gratification. They can seem, at first appearance, to be pleasurable, satisfying, and good. If we follow the temptations of the devil, we are, therefore, freely making a choice to do this. The extraordinary action of the devil (possession, vexation, obsession, and infestation) is not through any fault of the person. In addition, there are many more victims of the devil’s ordinary action, than his extraordinary action.

It should not surprise anyone if I say that there are more victims of Satan’s ordinary action, than of his extraordinary action. We are all victims of temptation, but only some are victims of the extraordinary action of Satan—but never through their own fault. Therefore, they are not morally responsible for Satan’s extraordinary actions.¹⁵

I am proposing that the psychopath is the human face of the devil. The interpersonal traits that characterize the psychopath—cunning, manipulation, lying, pride (a grandiose sense of self), and superficial charm, are the exact same features of the devil. Is this just a coincidence? Sadly, it is not. The moral and spiritual dimensions of the human person are least understood in our present times. It is the wisdom of the Church which provides the full truth about the reality of these dimensions.

Cunning and Manipulative
These traits are not mutually exclusive, in the sense that to have one of these traits, in essence, is to have also the others. What I mean by this is that pathological lying and superficial charm are the means employed by psychopaths to manipulate people. The devil is cunning and manipulative and seeks to entrap us through the lies he whispers to us. He can only allure us with what seems good—that which glitters and charms on the exterior.

Superficial Charm
The prince of this world entices and charms us with the things that glitter, and which fulfill our nature’s need for immediate gratification. While they satisfy us temporarily, we will suffer interiorly if we develop an attachment to them. If this becomes excessive, then we will suffer from an insatiable thirst to attain more power, honor, pleasure, or wealth. In order to satisfy this thirst, the person will have to employ malice and deceit to attain their goal. The person becomes transformed, so to speak, into the properties of the worldly object’s exterior. Gleaming gold on the outside which will hide the evil employed to attain the object of adoration. This is what happens to the psychopath—their superficial charm hides a heart filled with venom and hatred. Their ability to charm other people, to achieve their own perverted ends, is one of their distinctive qualities.

Pathological lying
Divine revelation teaches that the devil is the father of all lies. “He was a murderer from the start; he was never grounded in the truth; there is no truth in him at all. When he lies he is speaking true to his nature, because he is a liar, and the father of lies.” A key characteristic of the psychopath is their pathological lies. They just don’t lie now and again, they are pathological, or completely disordered, in the lies they tell. It is as if they cannot tell the truth. Sadly, this is also the true nature of the devil who has no truth in him at all.

Grandiose Sense of Self
The grandiose sense of self that characterizes the psychopath is what is also known in Christianity as the capital sin of pride. Pride is the root of all sin, as it involves a turning away from God, our creator, and a turning inward on oneself. The inordinate belief in one’s own excellence is a core attribute of the devil. So, it is an attribute that is consistent over time and place. We can all have pride-filled moments, where we think we are right and better than someone else. The attitude of the psychopath is that their belief in their superiority over others is a permanent feature of their personality.

Another chilling fact, revealed through the tradition of the Church, is that because man has greater freedom than the devil, he can become even worse than the devil himself. Is this an exaggeration? Is this just medieval absurdity from the dark ages of civilization? However, the truth is always uncomfortable. The discomforting reality of the human person is their capacity to develop a liking and love for evil—a sheer delight in inflicting the most brutal cruelty onto another person. They have freely consented to the perverse will and imagination of the devil. The key point which cannot be emphasized enough, is that this is their free choice. The devil, on the other hand, can act only by the divine permission.

She was accustomed to say “….For man, unassisted by God’s grace, is even worse than the devil, because the devil is a spirit without a body; while man, without the grace of God, is a devil incarnate. Man has a free will, which, according to the ordination of God, is in nowise bound, so that he can do all the evil he wills; to the devil, this is impossible, since he can act only by the divine permission; and when man surrenders to him his evil will, the devil employs it, as the instrument (of) his temptation.”¹⁶

Why do People Become Psychopaths?
In this essay, I hope I have been able to show the reader that what ultimately makes a psychopath is both the rejection of actual grace, and the love of evil. By continually rejecting the opportunities God sends us in order to see and taste reality, we, by default, have to follow a path that is outside the realm of truth. We see this in the person saddled with addiction, who continually blames others for their predicament, and views themselves as a victim of society. They justify their addiction, and crimes to fund their habit, through this distorted worldview. Their conscience, other people, and the troubles and difficulties they experience, are all trying to tell them to open their eyes, and to perceive the reality of their situation.

So, the person who is sunken in drug addiction rejects the actual graces they receive, and maintains their habit through the commission of illegal activities. While someone may have this attitude, they still have the capacity to refuse to commit certain crimes—such as crimes against the vulnerable, that inflict harm over and above what is required while delighting in the crime itself; or committing a crime as a means to an end—the end being the funding of their drug habit. The fact that their internal resources are limited, does not mean they are any more likely to commit horrendous acts than anyone else.

Why does someone then not only reject actual graces, but also commit horrendous evil acts? A person committed to the path of evil will be prey to the devil, and all his deceitful suggestions. And so the evil desires of the devil will become the material of the person’s imagination. They take a perverse delight in the evil fantasies they play in their imagination, as well as the evil acts they commit. Fantasy is always one step ahead of what has already been committed in reality. This explains why people tend to escalate the seriousness of the crimes that they commit. One of the behavioral traits of the psychopath is criminal versatility—there is not one particular pattern of offending. They are different for the person supporting a drug addiction, who commits thefts and burglaries to support their habit. The psychopath is chained to the perverse fantasies of the devil, and because the devil is absolutely pure evil, he is able to inspire people to commit acts of evil across the entire spectrum of human behavior. They desire to act out the horrendous script which they secretly play to themselves, delighting in the evil which they are imagining.

To willfully commit sin with malice, in a planned and premeditated manner, is to be in a state of blindness through the loss of the light of reason, while also delighting in the wrong-doing, while knowing deep down that it is wrong. This is a contradictory state that is completely disintegrated and disfigured, reflecting the qualities of Satan: the one who scatters and seduces. He scatters the mind, heart, and will, and seduces the imagination.

Given the characteristics of the psychopath, treatment approaches have produced mixed results. In the main, the psychopath is viewed as untreatable. Given their innate ability to be able to manipulate and deceive other people, is it any wonder that their response to treatment is poor. Much debate has ensued within the criminological and psychological fields about the treatability of the psychopath.

However, what is clear is that within the biblical world, no one is shut off from receiving the merciful love of God. It is his mercy that provides hope for a heart sunken in sin—psychopath, or otherwise. The real, and only cure for the psychopath is a repentant heart.