It is the question that reverberates across the country, the proverbial shot across the bow, as this fateful election draws closer.
How could he be so shameless, derelict and arrogant? How could he inflict so much damage without a smidgeon of remorse, but rather an abundance of vainglory?
Herein is one clinician’s attempt to provide an answer to that question. An answer not gleamed by focusing on the man himself or the black hole of all his destructive transactions; but rather by describing the condition he possesses.
Psychopathic personality disorder is one of the most comprehensively researched and thoroughly validated conditions in the field of psychopathology. If someone meets the rigorous diagnostic criteria for the disorder, there is a lot we can say about them objectively and scientifically – the etiology and course of their condition, their brain abnormalities, the rigidity of their condition, the set of measurable destructive personality traits that defines their affliction.
However, it has been more difficult to describe the subjective life of the psychopath – what is like to be a psychopath. To acquire that understanding we can’t turn to the psychopath himself. There are few first-person accounts of psychopathy. And other than descriptions of the cold-bloodedness they bring to their crimes and transgressions, they provide little insight into the experience of being a psychopath. And, no wonder, psychopathy is mostly about the absence of human qualities. It would be like asking someone to describe a color to which they have been born blind.
Works of fiction and journalism are pretty much restricted to the stories of serial killers, and therefore can be misleading about the wider population of psychopaths (although Norman Mailer’s Executioners’s Song has much to recommend it). 2
The best source for understanding the world of the psychopath comes from those clinicians and researchers that have devoted their attention to it. One of the best is Martha Stout, author of the bestselling The Sociopath Next Door (2005). She starts her book with a thought exercise that, er, might remind you of someone:
Imagine—if you can—not having a conscience, none at all, no feelings of guilt or remorse no matter what you do, no limiting sense of concern for the well-being of strangers, friends, or even family members. Imagine no struggles with shame, not a single one in your whole life, no matter what kind of selfish, harmful, or immoral action you have taken…Now add to this strange fantasy the ability to conceal from other people that your psychological makeup is radically different from theirs. Since everyone simply assumes that conscience is universal among human beings, hiding the fact that you are conscience-free is nearly effortless…You can do anything at all, and still your strange advantage over the majority of people, who are kept in line by their conscience, will most likely remain undiscovered…Maybe you are someone who craves money and power, and though you have no vestige of conscience, you do have a magnificent IQ. You have the driving nature and intellectual capacity to pursue tremendous wealth and influence, and you are in no way moved by the nagging voice of conscience…You choose business, politics, law, banking, or any of a broad array of other power professions, and you pursue your career with a cold passion that tolerates none of the usual moral or legal encumbrances. When it is expedient you doctor the accounting and shred the evidence, you stab your employees (or your constituency) in the back, tell lethal premeditated lies to people who trust you, attempt to ruin colleagues who are powerful or eloquent, and simply steamroll over groups who are dependent and voiceless… You have a special talent for whipping up other people’s hatred and sense of deprivation… And all this you do with the exquisite freedom that results from having no conscience whatsoever…You become unimaginably, unassailably, and maybe even globally successful. Why not? With your big brain, and no conscience to rein in your schemes, you can do anything at all. (p. 1)
It should be noted that Stout wrote this before Trump walked onto the political landscape. It is unlikely she had him in mind. She was describing a common trajectory of a psychopath, not a particular individual. Experts on psychopathy place this lack of conscience, this remorselessness at the center of the disorder.
To have a conscience is such a deep, innate part of being human, it is difficult to imagine not possessing one. It’s hard to imagine having no fear about being found out for moral transgressions, no compunction about lying, and no gut-level reservations about acts that might harm others. Not having a conscience is like having a car without brakes.
Conscience is the glue that keeps the social fabric from unraveling. It undergirds the social contract that promotes decency, safety, and trust. Yet there is that small percentage that live outside that social contract, that 1% who, in the apt phrase of Hervey Cleckley, “carry disaster lightly in both hands.” Is it not desirable to identify those without a conscience, particularly if they are in a position of power over others?
Well, one could argue, the inability of the brain and nervous system to generate the inhibitory emotions of guilt, shame and fear—that are foundational to developing a conscience—doesn’t have to result in predatory or harmful behavior. Just because one lacks the capacity to feel bad about doing bad, doesn’t necessarily mean one can’t feel good about doing good. Just because one is not constrained by feelings of guilt or shame, doesn’t mean one can’t be motivated by feelings of love or virtue.
However, this is where we careen into the second ditch in the psychopath’s interior landscape: the inability to empathize or care deeply. This was the central trait Cleckley noted in Mask of Sanity, “beauty and ugliness (except in a very superficial sense), goodness, evil, love, horror, and humor have no actual meaning, no power to move him.” We have already noted that when images of suffering are presented to the psychopath, there is no activity in the emotional centers of the brain. It is an ice station as far as empathy and deep caring are concerned.
Martha Stout makes a link between the difficulty to form a deep bond with others and the absence of a conscience. She defines conscience as the “intervening sense of obligation based on our attachment to others.” But if someone simply cannot experience the deeper feelings of love, tenderness, or compassion, then they have no motivation to protect, sacrifice, or feel responsible. If others just don’t matter much, there is no motivation to build a conscience. Instead of expressions of empathy, there are acts of callousness.
This missing gear to connect deeply is reflected in the marriages of psychopaths. Stout notes, “once the surface charm is scraped off, their marriages are loveless, one-sided and almost always short-term. If a marriage partner has any value to the sociopath, it is because the partner is viewed as a possession, one that the sociopath may feel angry to lose, but never evoke sadness or accountability.”
However, it would be misleading to suggest that the psychopath is disengaged entirely from relationships. Experts in marital therapy and interpersonal communications note that in any serious relationship there is a complex dance that revolves around two questions: (1) “how close do l want to get to this person?” and (2) “who is on top?” In serious relationships, there is this ongoing dance of intimacy and power. The psychopath does not have the neurological infrastructure to even get on the dance floor of intimacy. But he is kinetic with dance moves of asserting power.
Since dominance and “winning” is the only dance card available to him, the psychopath often becomes adept at it. His focus is one-dimensional and aggressive (“grab ‘em by the pussy”). He concentrates on immediate gains and gratifications driven by his egocentric needs. Relationships are instrumental. People are means, not ends, in themselves.
And the psychopath has plenty of emotional fuel. Admittedly, not the animating force that flows from love, compassion and empathy; but emotions associated with the drive to dominate such as anger, glee, resentment. envy, consternation, jealousy, and contempt. These emotions are shallow and often fleeting, but can be intense in the moment, and typically drive the psychopath’s behavior.
The psychopath is out to dominate his relationships. That is his exclusive goal. He may recognize (cognitive empathy) the rewards for acting as if he cares for someone. And this self-interest may serve as a check on his behavior for a while. He may even enter professions where the opportunities for prosocial behavior abound—medicine, law, politics, business, and even religion. But exploitation and harm eventually win out.
Over time, this wiring of the psychopath, which doesn’t allow him to care, but only operate in the gear of “winning” in a relationship (whether with a spouse, friend, colleague, or country), means that he will always be drawn to actions that benefit him and disadvantage the other. This may start out as mere selfishness and lack of reciprocity, but inevitably moves to dereliction and cruelty.
Specific items from the Hare Psychopathy Checklist that are linked to this core inability to empathize and care include: promiscuous sexual relationships, callousness, parasitic lifestyle, frequent marital relationships, shallow affect, and the tendency to be cunning and manipulative.
To not be able to care deeply is an affliction. It is sad (seriously). But to be in a relationship with such a person is risky. It is not only driving a car without brakes (lack of conscience), but also a car that can only operate in one gear (domination) that will eventually strip the transmission (relationship) to shreds.
But wait…it gets worse. 4
David Shapiro, author of the classic text,Neurotic Styles (1965), made groundbreaking observations of the psychopathic condition, which he saw as a variant of a more general impulsive mode of limited functioning. He was able to bring to life the narrow bandwidth of the psychopath’s consciousness and pinpoint the deficiencies that constitute this sad, but also dangerous condition. His observations were prescient: they anticipated the findings of brain research conducted later.
Shapiro describes the psychopath as one who is enslaved to his impulses and whims. As he goes through the day, the psychopath is not able to engage the world beyond the immediately present and personally relevant (“what’s in it for me?”). For the psychopath, an impulse is not something fleeting, to be evaluated in the context of deeper interests, long-term goals or moral concerns. For most of us, an impulse—triggered easily and often in the more ancient, lower, emotional parts of our brain—evokes the beginning of a process, where the impulse is mediated by the higher functions of judgement, self-control, and conscience, located primarily in the cerebral cortex.
But not for the psychopath. For him, the impulse—triggered by the immediate frustrations and opportunities of the moment—is acted out quickly. The behavior of the psychopath is therefore labile and erratic. It can turn this way or that based on his rapid-fire “what’s in it for me?” appraisal of the immediate situation. The behavior is egocentric and, often exploitive. This was Phineas George after his accident. This can be college sophomores at a party who engage in binge-drinking and are then at significant risk for sexual assault because the excessive alcohol shuts down that part of the brain that curbs impulses.
The feelings that accompany this impulsive style are shallow and primitive, typically restricted to the arena of pain vs. pleasure, and frustration vs. gratification of the immediate situation. Since there is a diminished capacity to process emotions in the higher levels of the brain, there is no refinement of feelings that occurs when impulses are weighed against long-term interests or the strictures of conscience.
For the psychopath, life is ruled by impulse. Their attention is easily captured and rarely goes beyond the egocentric interests of the concrete present. Impulse is not occasional, but regular. Impulse is not the beginning of a process of weighing, deliberating and mindful choosing, but the short-circuiting of it.
Shapiro emphasizes that this “life ruled by impulse” does not represent a disruption of executive functioning, but rather a deficiency of executive functioning. When an impulse is triggered, the deficiencies in these higher-level mental functions means there is no counterweight to it.
Imagine a married man with this condition who meets an attractive woman at an out of town conference and, in sizing things up, believes he can hook up with her. His ability to measure what might be tempting in the moment against what it might mean in two months is…just not there. Nor is the predisposition to weigh the moral consequence of such a sexual encounter. The calls most of us make every day between “l want” vs. “l should” just don’t take place with a psychopath. He has only one play available to him: the short game of winning the moment.
Thus, the behavior of the psychopath should not be viewed so much as immoral, as amoral. He is not violating his moral scruples. He is simply acting sensibly with regard to the opportunities of the moment. That such behavior is predatory is a problem for people in his orbit, not for him. Elizabeth Stout emphasized the psychopath’s inability to develop a loving bond with another. David Shapiro would argue there is a more fundamental inability to develop any deep allegiances: to a significant other yes, but also to friends, the community, even ideas and values. The cognitive and affective infrastructure to develop stable and deeper interests and bonds is…just not there.
This inability to develop aims and values beyond the immediate tangible gain should not be confused with a lack of intelligence. Indeed, as Shapiro observes, it can convey certain advantages:
It is well to remember, however, that the impulsive style may, in certain areas of living, be quite adaptive. These areas seem, in general, to be ones where readiness for quick action or expression and/or a facility and competence of a sort that be developed in pursuit of immediate and egocentric interests can be useful. It is well known, for example, that many impulsive people possess considerable social facility and are often socially very charming and engaging. They may also be quite playful, in contrast, for instance, to the heavy, over deliberate, and somewhat dull quality of some obsessive-compulsive people, and, given a good intellectual endowment, they may be witty and entertaining. There is no doubt also, that many actual as well as fictional “men of action,” have excellent practical competency and a capacity for quick and unhesitating action… have a keen, practical intelligence that is suited to the competent execution of their short-range, immediate aims. (p. 147)
It is not surprising that some psychopaths attain significant wealth and power, given their cunning and singular drive to dominate. Pathological lying, one of the twenty items on the Hare Psychopathy Checklist, can be understood as an expression of this impulsive style. Pathological lying, as operationalized in the Checklist, does not refer to the enormity of a lie, but to its frequency. A big lie (e.g., promoting a fraudulent university) usually requires some planning and deliberation. The big lie, of course, represents problematic behavior and is related to the psychopathic condition. However, it is accounted for in the Checklist in the item labelled “conning.”
Pathological lying refers to lying frequently. The quality of such lying is casual, glib, “off the top of the head” (see his riffs at his rallies and debate performances for good examples of this style). The pathological liar often contradicts himself within minutes (but shows scant concern for the contradiction). The lying can occur over what seem like the most trivial of matters. The impulsive mode helps explain this trait. The psychopath is stuck in the gear of winning the moment, “getting by,” “operating” (in business vernacular “always working on the closing”). The lying is often an embellishment, meant to impress or gain an advantage, even if only slightly. And he is at the mercy of saying quickly whatever meets his egocentric needs of the moment (there are many examples of this behavior from his press briefings in the early days of the coronavirus crisis, where he would say something that ‘won the moment’ but needed to be immediately corrected by experts). He has no buffer of aims or values to deflect the drive for the immediate, tangible gain. Consequences to others are not in his purview.
The psychopath is not interested in what is being said, but how it works for him. Logic, objectivity or the simple desire to be truthful are not part of his mindset. Truth is transactional. The psychopath speaks power to truth. Items from the Hare Psychopathy Checklist that emanate from this impulsive mode of functioning include glibness/superficial charm, short-tempered/poor behavioral controls, pathological lying, lack of realistic long-term planning, promiscuous sexual relationships, and superficial emotional responsiveness.
To live a life ruled by impulse is like driving a car without a GPS. To be caught in traffic with such a car is hazardous, because the car also has no turn signals or brake lights and is prone to jerking this way or that without any concern for its fellow drivers. And the driver of the car? Well, he has all the self-control of a Don Draper chugging his way thru a bottle of gin.
These three cardinal traits—absence of conscience, inability to empathize or bond deeply with others, and impulsiveness—are at the heart of the disorder and mark psychopaths, in Elizabeth Stout’s words, as “a group unto themselves.” They lead a life driven by egocentric impulses, which are unmodulated by conscience or concern for others. They lack the humanizing and self-control functions which most of us take for granted.
To re-visit the car analogy, this psychopathic model, while it may look sleek, is hazardous. Remember, it has only one gear (to dominate), which is destined to shred the engine and no brakes (conscience). If you could somehow get this vehicle to a repair shop before it was totaled in an accident, and raise it up on a hydraulic lift, you would discover that there is no repair called for, no damage to be fixed. Rather, you would see that there simply is no system of brakes, no multiple gears, no GPS. These basic systems necessary to drive a car safely are…just not there.
Of course, with a car, you could order the missing parts and replace these missing systems. And it’s true with the human body we are now capable of replacing major organs such as the heart, kidney or lungs. But we don’t yet have the medical technology to replace missing parts of the brain. l mean Dr. Frankenstein tried, but we saw how that turned out.
To be in the path of a psychopath is to put oneself in harm’s way. The risk to others is inherent in many of his destructive personality traits—deception, lying, breathtaking callousness, engagement in more than one type of criminal activity. For a psychopath who is in a position of significant power and authority, other manifestations of his condition bode ill for those under his sway. These would include the inability to act predictably, the inability to react calmly and without aggression, the inability to examine his own behavior and accept responsibility, the inability to respect boundaries and limits, and the inability to place the interests of others or the common good above his own.
All of these tendencies have the gravitational pull of a black hole. Over time, the social network over which the psychopath has influence slides toward disruption and deterioration. This storm of ruinous traits is not going to dissipate. No repair is possible. The best we can do is recognize its presence and try to protect ourselves.