Aule
07-24-2007, 08:36 AM
Has anyone here ever encountered a person IRL who fits the description of a "sub-clinical" sociopath? The only person I can think of off hand as falling into this category would be my stepmother's eldest son. He could never keep a stable job, routinely tortured small animals, stole gas from three different gas stations whilst travelling cross country and was finally caught with a mountain of child porn stashed in his trunk. He's now serving an eight year sentence in a federal penitentiary on the Kentucky-Ohio border.
PSYCHOPATHS AMONG US
Dr. Robert Hare claims there are 300,000 psychopaths in Canada, but that only a tiny fraction are violent offenders like Paul Bernardo and Clifford Olsen. Who are the rest? Take a look around
By Robert Hercz
"Psychopath! psychopath!"
I'm alone in my living room and I'm yelling at my TV. "Forget rehabilitation -- that guy is a psychopath."
Ever since I visited Dr. Robert Hare in Vancouver, I can see them, the psychopaths. It's pretty easy, once you know how to look. I'm watching a documentary about an American prison trying to rehabilitate teen murderers. They're using an emotionally intense kind of group therapy, and I can see, as plain as day, that one of the inmates is a psychopath. He tries, but he can't muster a convincing breakdown, can't fake any feeling for his dead victims. He's learned the words, as Bob Hare would put it, but not the music.
The incredible thing, the reason I'm yelling, is that no one in this documentary -- the therapists, the warden, the omniscient narrator -- seems to know the word "psychopath." It is never uttered, yet it changes everything. A psychopath can never be made to feel the horror of murder. Weeks of intense therapy, which are producing real breakthroughs in the other youths, will probably make a psychopath more likely to reoffend. Psychopaths are not like the rest of us, and everyone who studies them agrees they should not be treated as if they were.
I think of Bob Hare, who's in New Orleans receiving yet another award, and wonder if he's watching the same show in his hotel room and feeling the same frustration. A lifetime spent looking into the heads of psychopaths has made the slight, slightly anxious emeritus professor of psychology at the University of British Columbia the world's best-known expert on the species. Hare hasn't merely changed our understanding of psychopaths. It would be more accurate to say he has created it.
The condition itself has been recognized for centuries, wearing evocative labels such as "madness without delirium" and "moral insanity" until the late 1800s, when "psychopath" was coined by a German clinician. But the term (and its 1930s synonym, sociopath) had always been a sort of catch-all, widely and loosely applied to criminals who seemed violent and unstable. Even into the mid-1970s, almost 80 percent of convicted felons in the United States were being diagnosed as sociopaths. In 1980, Hare created a diagnostic tool called the Psychopathy Checklist, which, revised five years later, became known as the PCL-R. Popularly called "the Hare," the PCL-R measures psychopathy on a forty-point scale. Once it emerged, it was the first time in history that everyone who said "psychopath" was saying the same thing. For research in the field, it was like a starting gun.
But for Hare, it has turned out to be a Pandora's box. Recently retired from teaching, his very last Ph.D. student about to leave the nest, Hare, sixty-eight, should be basking in professional accolades and enjoying his well-earned rest. But he isn't.
The PCL-R has slipped the confines of academe, and is being used and misused in ways that Hare never intended. In some of the places where it could do some good -- such as the prison in the TV documentary I was yelling at -- the idea of psychopathy goes unacknowledged, usually because it's politically incorrect to declare someone to be beyond rehabilitation. At the opposite extreme, there are cases in which Hare's work has been overloaded with political baggage of another sort, such as in the United States, where a high PCL-R score is used to support death-penalty arguments, and in England, where a debate is underway about whether some individuals with personality disorders (such as psychopaths) should be detained even if they haven't committed a crime.
So, after decades of labour in peaceful obscurity, Bob Hare has become a man with a suitcase, a passport, and a PowerPoint presentation, a reluctant celebrity at gatherings of judges, attorneys, prison administrators, psychologists, and police. His post-retirement mission is to be a good shepherd to his Psychopathy Checklist.
"I'm protecting it from erosion, from distortion. It could easily be compromised," he says. "I'm a scientist; I should just be doing basic research, but I'm being called on all the time to intervene and mediate."
And it's really just beginning. Psychopathy may prove to be as important a construct in this century as IQ was in the last (and just as susceptible to abuse), because, thanks to Hare, we now understand that the great majority of psychopaths are not violent criminals and never will be. Hundreds of thousands of psychopaths live and work and prey among us. Your boss, your boyfriend, your mother could be what Hare calls a "subclinical" psychopath, someone who leaves a path of destruction and pain without a single pang of conscience. Even more worrisome is the fact that, at this stage, no one -- not even Bob Hare -- is quite sure what to do about it.
Bob hare has to meet me in the lobby of the UBC psychology building, since he's not listed in the directory. He's had threats, by e-mail and in person. An ex-con showed up one day, angry that a friend of his had been declared a dangerous offender thanks to Hare's checklist. Other characters have appeared in his lab doorway, looking in and saying nothing.
We immediately find ourselves discussing the criminal du jour, the jet-setting French con man Christophe Rocancourt, notorious for passing himself off as a member of the Rockefeller family, who has just been arrested in Victoria.
"I'd sure as hell like to have a close look at him," Hare muses.
Like every scientist, Hare likes a good puzzle, and that was reason enough to make a career out of psychopaths. "These were particularly interesting human beings," he says. "Everything about them seemed to be paradoxical. They could do things that a lot of other people could not do" -- lie, steal, rape, murder -- "but they looked perfectly normal, and when you talked to them they seemed okay. It was a puzzle. I thought I'd try and unravel it."
Hare arrived at UBC in 1963, intending to follow up his doctoral research on punishment. Certain prisoners, it was rumoured, didn't respond to punishment, and Hare went to the federal penitentiary in New Westminster, British Columbia, to find these extreme cases. (He found plenty. In his chilling 1993 book on psychopathy, Without Conscience: The Disturbing World of the Psychopaths Among Us, he quotes one specimen's memories: "[M]y mother, the most beautiful person in the world. She was strong, she worked hard to take care of four kids. A beautiful person. I started stealing her jewellery when I was in the fifth grade. You know, I never really knew the bitch -- we went our separate ways.")
For his first paper, now a classic, Hare had his subjects watch a countdown timer. When it reached zero, they got a "harmless but painful" electric shock while an electrode taped to their fingers measured perspiration. Normal people would start sweating as the countdown proceeded, nervously anticipating the shock. Psychopaths didn't sweat. They didn't fear punishment -- which, presumably, also holds true outside the laboratory. In Without Conscience, he quotes a psychopathic rapist explaining why he finds it hard to empathize with his victims: "They are frightened, right? But, you see, I don't really understand it. I've been frightened myself, and it wasn't unpleasant."
In another Hare study, groups of letters were flashed to volunteers. Some of them were nonsense, some formed real words. The subject's job was to press a button whenever he recognized a real word, while Hare recorded response time and brain activity. Non-psychopaths respond faster and display more brain activity when processing emotionally loaded words such as "rape" or "cancer" than when they see neutral words such as "tree." With psychopaths, Hare found no difference. To them, "rape" and "tree" have the same emotional impact -- none.
Hare made another intriguing discovery by observing the hand gestures (called beats) people make while speaking. Research has shown that such gestures do more than add visual emphasis to our words (many people gesture while they're on the telephone, for example); it seems they actually help our brains find words. That's why the frequency of beats increases when someone is having trouble finding words, or is speaking a second language instead of his or her mother tongue. In a 1991 paper, Hare and his colleagues reported that psychopaths, especially when talking about things they should find emotional, such as their families, produce a higher frequency of beats than normal people. It's as if emotional language is a second language -- a foreign language, in effect -- to the psychopath.
Three decades of these studies, by Hare and others, has confirmed that psychopaths' brains work differently from ours, especially when processing emotion and language. Hare once illustrated this for Nicole Kidman, who had invited him to Hollywood to help her prepare for a role as a psychopath in Malice. How, she wondered, could she show the audience there was something fundamentally wrong with her character?
"I said, 'Here's a scene that you can use,' " Hare says. " 'You're walking down a street and there's an accident. A car has hit a child in the crosswalk. A crowd of people gather round. You walk up, the child's lying on the ground and there's blood running all over the place. You get a little blood on your shoes and you look down and say, "Oh shit." You look over at the child, kind of interested, but you're not repelled or horrified. You're just interested. Then you look at the mother, and you're really fascinated by the mother, who's emoting, crying out, doing all these different things. After a few minutes you turn away and go back to your house. You go into the bathroom and practice mimicking the facial expressions of the mother.' " He then pauses and says, "That's the psychopath: somebody who doesn't understand what's going on emotionally, but understands that something important has happened."
Hare's research upset a lot of people. Until the psychopath came into focus, it was possible to believe that bad people were just good people with bad parents or childhood trauma and that, with care, you could talk them back into being good. Hare's research suggested that some people behaved badly even when there had been no early trauma. Moreover, since psychopaths' brains were in fundamental ways different from ours, talking them into being like us might not be easy. Indeed, to this day, no one has found a way to do so.
"Some of the things he was saying about these individuals, it was unheard of," says Dr. Steven Stein, a psychologist and ceo of Multi-Health Systems in Toronto, the publisher of the Psychopathy Checklist. "Nobody believed him thirty years ago, but Bob hasn't wavered, and now everyone's where he is. Everyone's come full circle, except a small group who believe it's bad upbringing, family poverty, those kinds of factors, even though scientific evidence has shown that's not the case. There are wealthy psychopaths who've done horrendous things, and they were brought up in wonderful families."
"There's still a lot of opposition -- some criminologists, sociologists, and psychologists don't like psychopathy at all," Hare says. "I can spend the entire day going through the literature -- it's overwhelming, and unless you're semi-brain-dead you're stunned by it -- but a lot of people come out of there and say, 'So what? Psychopathy is a mythological construct.' They have political and social agendas: 'People are inherently good,' they say. 'Just give them a hug, a puppy dog, and a musical instrument and they're all going to be okay.' "
If Hare sounds a little bitter, it's because a decade ago, Correctional Service of Canada asked him to design a treatment program for psychopaths, but just after he submitted the plan in 1992, there were personnel changes at the top of CSC. The new team had a different agenda, which Hare summarizes as, "We don't believe in the badness of people." His plan sank without a trace.
By the late 1970s, after fifteen years in the business, Bob Hare knew what he was looking for when it came to psychopaths. They exhibit a cluster of distinctive personality traits, the most significant of which is an utter lack of conscience. They also have huge egos, short tempers, and an appetite for excitement -- a dangerous mix. In a typical prison population, about 20 percent of the inmates satisfy the Hare definition of a psychopath, but they are responsible for over half of all violent crime.
The research community, Hare realized, lacked a standard definition. "I found that we were all talking a different language, we were on different diagnostic pages, and I decided that we had to have some common instrument," he says. "The PCL-R was really designed to make it easier to publish articles and to let journal editors and reviewers know what I meant by psychopathy."
The Psychopathy Checklist consists of a set of forms and a manual that describes in detail how to score a subject in twenty categories that define psychopathy. Is he (or, more rarely, she) glib and superficially charming, callous and without empathy? Does he have a grandiose sense of self worth, shallow emotions, a lack of remorse or guilt? Is he impulsive, irresponsible, promiscuous? Did he have behavioural problems early in life? The information for each category must be carefully drawn from documents such as court transcripts, police reports, psychologists' reports, and victim-impact statements, and not solely from an interview, since psychopaths are superb liars ("pathological lying" and "conning/manipulative" are PCL-R categories). A prisoner may claim to love his family, for example, while his records show no visits or phone calls.
For each item, assessors -- psychologists or psychiatrists -- assign a score of zero (the item doesn't apply), one (the item applies in some respects), or two (the item applies in most respects). The maximum possible score is forty, and the boundary for clinical psychopathy hovers around thirty. Last year, the average score for all incarcerated male offenders in North America was 23.3. Hare guesses his own score would be about four or five.
In 1980, Hare's initial checklist began circulating in the research community, and it quickly became the standard. At last count nearly 500 papers and 150 doctoral dissertations had been based on it.
It's also found practical applications in police-squad rooms. Soon after he delivered a keynote speech at a conference for homicide detectives and prosecuting attorneys in Seattle three years ago, Hare got a letter thanking him for helping solve a series of homicides. The police had a suspect nailed for a couple of murders, but believed he was responsible for others. They were using the usual strategy to get a confession, telling him, 'Think how much better you'll feel, think of the families left behind,' and so on. After they'd heard Hare speak they realized they were dealing with a psychopath, someone who could feel neither guilt nor sorrow. They changed their interrogation tactic to, "So you murdered a couple of prostitutes. That's minor-league compared to Bundy or Gacy." The appeal to the psychopath's grandiosity worked. He didn't just confess to his other crimes, he bragged about them.
The most startling finding to emerge from Hare's work is that the popular image of the psychopath as a remorseless, smiling killer -- Paul Bernardo, Clifford Olson, John Wayne Gacy -- while not wrong, is incomplete. Yes, almost all serial killers, and most of Canada's dangerous offenders, are psychopaths, but violent criminals are just a tiny fraction of the psychopaths around us. Hare estimates that 1 percent of the population -- 300,000 people in Canada -- are psychopaths.
He calls them "subclinical" psychopaths. They're the charming predators who, unable to form real emotional bonds, find and use vulnerable women for sex and money (and inevitably abandon them). They're the con men like Christophe Rocancourt, and they're the stockbrokers and promoters who caused Forbes magazine to call the Vancouver Stock Exchange (now part of the Canadian Venture Exchange) the scam capital of the world. (Hare has said that if he couldn't study psychopaths in prisons, the Vancouver Stock Exchange would have been his second choice.) A significant proportion of persistent wife beaters, and people who have unprotected sex despite carrying the AIDS virus, are psychopaths. Psychopaths can be found in legislatures, hospitals, and used-car lots. They're your neighbour, your boss, and your blind date. Because they have no conscience, they're natural predators. If you didn't have a conscience, you'd be one too.
Psychopaths love chaos and hate rules, so they're comfortable in the fast-moving modern corporation. Dr. Paul Babiak, an industrial-organizational psychologist based near New York City, is in the process of writing a book with Bob Hare called When Psychopaths Go to Work: Cons, Bullies and the Puppetmaster. The subtitle refers to the three broad classes of psychopaths Babiak has encountered in the workplace.
"The con man works one-on-one," says Babiak. "They'll go after a woman, marry her, take her money, then move on and marry someone else. The puppet master would manipulate somebody to get at someone else. This type is more powerful because they're hidden." Babiak says psychopaths have three motivations: thrill-seeking, the pathological desire to win, and the inclination to hurt people. "They'll jump on any opportunity that allows them to do those things," he says. "If something better comes along, they'll drop you and move on."
How can you tell if your boss is a psychopath? It's not easy, says Babiak. "They have traits similar to ideal leaders. You would expect an ideal leader to be narcissistic, self-centred, dominant, very assertive, maybe to the point of being aggressive. Those things can easily be mistaken for the aggression and bullying that a psychopath would demonstrate. The ability to get people to follow you is a leadership trait, but being charismatic to the point of manipulating people is a psychopathic trait. They can sometimes be confused."
Once inside a company, psychopaths can be hard to excise. Babiak tells of a salesperson and psychopath -- call him John -- who was performing badly but not suffering for it. John was managing his boss -- flattering him, taking him out for drinks, flying to his side when he was in trouble. In return, his boss covered for him by hiding John's poor performance. The arrangement lasted until John's boss was moved. When his replacement called John to task for his abysmal sales numbers, John was a step ahead.
He'd already gone to the company president with a set of facts he used to argue that his new boss, and not he, should be fired. But he made a crucial mistake. "It was actually stolen data," Babiak says. "The only way [John] could have obtained it would be for him to have gone into a file into which no one was supposed to go. That seemed to be enough, and he was fired rather than the boss. Even so, in the end, he walked out with a company car, a bag of money, and a good reference."
"A lot of white-collar criminals are psychopaths," says Bob Hare. "But they flourish because the characteristics that define the disorder are actually valued. When they get caught, what happens? A slap on the wrist, a six-month ban from trading, and don't give us the $100 million back. I've always looked at white-collar crime as being as bad or worse than some of the physically violent crimes that are committed."
The best way to protect the workplace is not to hire psychopaths in the first place. That means training interviewers so they're less likely to be manipulated and conned. It means checking resumés for lies and distortions, and it means following up references.
Paul Babiak says he's "not comfortable" with one researcher's estimate that one in ten executives is a psychopath, but he has noticed that they are attracted to positions of power. When he describes employees such as John to other executives, they know exactly whom he's talking about. "I was talking to a group of human-resources executives yesterday," says Babiak, "and every one of them said, you know, I think I've got somebody like that."
By now, you're probably thinking the same thing. The number of psychopaths in society is about the same as the number of schizophrenics, but unlike schizophrenics, psychopaths aren't loners. That means most of us have met or will meet one. Hare gets dozens of letters and e-mail messages every month from people who say they recognize someone they know while reading Without Conscience. They go on to describe a brother, a sister, a husband. " 'Please help my seventeen-year-old son. . . .' " Hare reads aloud from one such missive. "It's a heart-rending letter, but what can I do? I'm not a clinician. I have hundreds of these things, and some of them are thirty or forty pages long."
Hare's book opened my eyes, too. Reading it, I realized that I might have known a psychopath, Jonathan, at the computer company where I worked in London, England, over twenty years ago. He was charming and confident, and from the moment he arrived he was on excellent terms with the executive inner circle. Jonathan had big plans and promised me that I was a big part of them. One night when I was alone in the office, Jonathan appeared, accompanied by what anyone should have recognized as two prostitutes. "These are two high-ranking staff from the Ministry of Defence," he said without missing a beat. "We're going over the details of a contract, which I'm afraid is classified top secret. You'll have to leave the building." His voice and eyes were absolutely persuasive and I complied. A few weeks later Jonathan was arrested. He had embezzled tens of thousands of pounds from the small firm, used the company as a mailing address for a marijuana importing business he was running on the side, and robbed the apartment of the company's owner, who was letting him stay there temporarily.
Like everyone who has been suckered by a psychopath -- and Bob Hare includes himself and many of his graduate students (who have been trained to spot them) in that list -- I'm ashamed that I fell for Jonathan. But he was brilliant, charismatic, and audacious. He radiated money and power (though in fact he had neither), while his real self -- manipulative, lying, parasitic, and irresponsible -- was just far enough under his surface to be invisible. Or was it? Maybe I didn't know how to look, or maybe I didn't really want to.
I saw his name in the news again recently. "A con man tricked top sports car makers Lotus into lending him a £70,000 model . . . then stole it and drove 6,000 miles across Europe, a court heard," the story began.
Knowing Jonathan is probably a psychopath makes me feel better. It's an explanation.
But away from the workplace, back in the world of the criminally violent psychopath, Hare's checklist has become broadly known, so broadly known, in fact, that it is now a constant source of concern for him. "People are misusing it, and they're misusing it in really strange ways," Hare says. "There are lots of clinicians who don't even have a manual. All they've seen is an article with the twenty items -- promiscuity, impulsiveness, and so forth -- listed."
In court, assessments of the same person done by defence and prosecution "experts" have varied by as much as twenty points. Such drastic differences are almost certainly the result of bias or incompetence, since research on the PCL-R itself has shown it has high "inter-rater reliability" (consistent results when a subject is assessed by more than one qualified assessor). In one court case, it was used to label a thirteen-year-old a psychopath, even though the PCL-R test is only meant to be used to rate adults with criminal histories. The test should be administered only by mental-health professionals (like all such psychological instruments, it is only for sale to those with credentials), but a social worker once used the PCL-R in testimony in a death-penalty case -- not because she was qualified but because she thought it was "interesting."
It shouldn't be used in death-penalty cases at all, Hare says, but U.S. Federal District Courts have ruled it admissible because it meets scientific standards.
"Bob and others like myself are saying it doesn't meet the ethical standards," says Dr. Henry Richards, a psychopathy researcher at the University of Washington. "A psychological instrument and diagnosis should not be a determinant of whether someone gets the death sentence. That's more of an ethical and political decision."
And into the ethical and political realm -- the realm of extrapolation, of speculation, of opinion -- Hare will not step. He's been asked to be a guest on Oprah (twice), 60 Minutes, and Larry King Live. Oprah wanted him alongside a psychopath and his victim. "I said, 'This is a circus,' " Hare says. "I couldn't do that." 60 Minutes also wanted to "make it sexy" by throwing real live psychopaths into the mix. Larry King Live phoned him at home while O. J. Simpson was rolling down the freeway in his white Bronco. Hare says no every time (while his publisher gently weeps).
Even in his particular area, Hare is unfailingly circumspect. Asked if he thinks there will ever be a cure for psychopathy -- a drug, an operation -- Hare steps back and examines the question. "The psychopath will say 'A cure for what?' I don't feel comfortable calling it a disease. Much of their behaviour, even the neurobiological patterns we observe, could be because they're using different strategies to get around the world. These strategies don't have to involve faulty wiring, just different wiring."
Are these people qualitatively different from us? "I would think yes," says Hare. "Do they form a discrete taxon or category? I would say probably -- the evidence is suggesting that. But does this mean that's because they have a broken motor? I don't know. It could be a natural variation." True saints, completely selfless individuals, are rare and unnatural too, he points out, but we don't talk about their being diseased.
Psychopathy research is raising more questions than it can answer, and many of them are leading to moral and ethical quagmires. For example: the PCL-R has turned out to be the best single predictor of recidivism that has ever existed; an offender with a high PCL-R score is three or four times more likely to reoffend than someone with a low score. Should a high PCL-R score, then, be sufficient grounds for denying parole? Or perhaps a psychopathy test could be used to prevent crime by screening individuals or groups at high risk -- for example, when police get a frantic "My boyfriend says he'll kill me" call, or when a teacher reports a student threatening to commit violence. Should society institutionalize psychopaths, even if they haven't broken the law?
The United Kingdom, partly in response to the 1993 abduction and murder of two-year-old James Bulger by two ten-year-olds, and partly in response to PCL-R data, is in the process of creating a new legal classification called Dangerous and Severe Personality Disorder (DSPD). As it stands, the government proposes to allow authorities to detain people declared DSPD, even if they have not committed a crime. (Sample text from one of the Web sites that have sprung up in response: "I was diagnosed with an untreatable personality disorder by a doctor who saw me for ten minutes, he later claimed I was a psychopath. . . . Please don't let them do this to me; don't let them do it to anybody. I'm not a danger to the public, nor are most mentally ill people.")
Hare is a consultant on the DSPD project, and finds the potential for abuse of power horrifying. So do scientists such as Dr. Richard Tees, head of psychology at UBC, a colleague of Hare's since 1965. "I am concerned about our political masters deciding that the PCL-R is the silver bullet that's going to fix everything," he says. "We'll let people out [of prison] on the basis of scores on this, and we'll put them in. And we'll take children who do badly on some version of this and segregate them or something. It wasn't designed to do any of these things. The problems that politicians are trying to solve are fundamentally more complicated than the one that Bob has solved."
So many of these awkward questions would vanish if only there were a functioning treatment program for psychopathy. But there isn't. In fact, several studies have shown that existing treatment makes criminal psychopaths worse. In one, psychopaths who underwent social-skills and anger-management training before release had an 82 percent reconviction rate. Psychopaths who didn't take the program had a 59 percent reconviction rate. Conventional psychotherapy starts with the assumption that a patient wants to change, but psychopaths are usually perfectly happy as they are. They enrol in such programs to improve their chances of parole. "These guys learn the words but not the music," Hare says. "They can repeat all the psychiatric jargon -- 'I feel remorse,' they talk about the offence cycle -- but these are words, hollow words."
Hare has co-developed a new treatment program specifically for violent psychopaths, using what he knows about the psychopathic personality. The idea is to encourage them to be better by appealing not to their (non-existent) altruism but to their (abundant) self-interest.
"It's not designed to change personality, but to modify behaviour by, among other things, convincing them that there are ways they can get what they want without harming others," Hare explains. The program will try to make them understand that violence is bad, not for society, but for the psychopath himself. (Look where it got you: jail.) A similar program will soon be put in place for psychopathic offenders in the UK.
"The irony is that Canada could have had this all set up and they could have been leaders in the world. But they dropped the ball completely," Hare says, referring to his decade-old treatment proposal, sitting on a shelf somewhere within Corrections Canada.
Even if Hare's treatment program works, it will only address the violent minority of psychopaths. What about the majority, the subclinical psychopaths milling all around us? At the moment, the only thing Hare and his colleagues can offer is self-protection through self-education. Know your own weaknesses, they advise, because the psychopath will find and use them. Learn to recognize the psychopath, they tell us, before adding that even experts are regularly taken in.
After thirty-five years of work, Bob Hare has brought us to the stage where we know what psychopathy is, how much damage psychopaths do, and even how to identify them. But we don't know how to treat them or protect the population from them. The real work is just beginning. Solving the puzzle of the psychopath is an invigorating prospect -- if you're a scientist. Perhaps the rest of us can be forgiven for our impatience to see the whole thing come to an end.
Source (http://www.hare.org/links/saturday.html)
PSYCHOPATHS AMONG US
Dr. Robert Hare claims there are 300,000 psychopaths in Canada, but that only a tiny fraction are violent offenders like Paul Bernardo and Clifford Olsen. Who are the rest? Take a look around
By Robert Hercz
"Psychopath! psychopath!"
I'm alone in my living room and I'm yelling at my TV. "Forget rehabilitation -- that guy is a psychopath."
Ever since I visited Dr. Robert Hare in Vancouver, I can see them, the psychopaths. It's pretty easy, once you know how to look. I'm watching a documentary about an American prison trying to rehabilitate teen murderers. They're using an emotionally intense kind of group therapy, and I can see, as plain as day, that one of the inmates is a psychopath. He tries, but he can't muster a convincing breakdown, can't fake any feeling for his dead victims. He's learned the words, as Bob Hare would put it, but not the music.
The incredible thing, the reason I'm yelling, is that no one in this documentary -- the therapists, the warden, the omniscient narrator -- seems to know the word "psychopath." It is never uttered, yet it changes everything. A psychopath can never be made to feel the horror of murder. Weeks of intense therapy, which are producing real breakthroughs in the other youths, will probably make a psychopath more likely to reoffend. Psychopaths are not like the rest of us, and everyone who studies them agrees they should not be treated as if they were.
I think of Bob Hare, who's in New Orleans receiving yet another award, and wonder if he's watching the same show in his hotel room and feeling the same frustration. A lifetime spent looking into the heads of psychopaths has made the slight, slightly anxious emeritus professor of psychology at the University of British Columbia the world's best-known expert on the species. Hare hasn't merely changed our understanding of psychopaths. It would be more accurate to say he has created it.
The condition itself has been recognized for centuries, wearing evocative labels such as "madness without delirium" and "moral insanity" until the late 1800s, when "psychopath" was coined by a German clinician. But the term (and its 1930s synonym, sociopath) had always been a sort of catch-all, widely and loosely applied to criminals who seemed violent and unstable. Even into the mid-1970s, almost 80 percent of convicted felons in the United States were being diagnosed as sociopaths. In 1980, Hare created a diagnostic tool called the Psychopathy Checklist, which, revised five years later, became known as the PCL-R. Popularly called "the Hare," the PCL-R measures psychopathy on a forty-point scale. Once it emerged, it was the first time in history that everyone who said "psychopath" was saying the same thing. For research in the field, it was like a starting gun.
But for Hare, it has turned out to be a Pandora's box. Recently retired from teaching, his very last Ph.D. student about to leave the nest, Hare, sixty-eight, should be basking in professional accolades and enjoying his well-earned rest. But he isn't.
The PCL-R has slipped the confines of academe, and is being used and misused in ways that Hare never intended. In some of the places where it could do some good -- such as the prison in the TV documentary I was yelling at -- the idea of psychopathy goes unacknowledged, usually because it's politically incorrect to declare someone to be beyond rehabilitation. At the opposite extreme, there are cases in which Hare's work has been overloaded with political baggage of another sort, such as in the United States, where a high PCL-R score is used to support death-penalty arguments, and in England, where a debate is underway about whether some individuals with personality disorders (such as psychopaths) should be detained even if they haven't committed a crime.
So, after decades of labour in peaceful obscurity, Bob Hare has become a man with a suitcase, a passport, and a PowerPoint presentation, a reluctant celebrity at gatherings of judges, attorneys, prison administrators, psychologists, and police. His post-retirement mission is to be a good shepherd to his Psychopathy Checklist.
"I'm protecting it from erosion, from distortion. It could easily be compromised," he says. "I'm a scientist; I should just be doing basic research, but I'm being called on all the time to intervene and mediate."
And it's really just beginning. Psychopathy may prove to be as important a construct in this century as IQ was in the last (and just as susceptible to abuse), because, thanks to Hare, we now understand that the great majority of psychopaths are not violent criminals and never will be. Hundreds of thousands of psychopaths live and work and prey among us. Your boss, your boyfriend, your mother could be what Hare calls a "subclinical" psychopath, someone who leaves a path of destruction and pain without a single pang of conscience. Even more worrisome is the fact that, at this stage, no one -- not even Bob Hare -- is quite sure what to do about it.
Bob hare has to meet me in the lobby of the UBC psychology building, since he's not listed in the directory. He's had threats, by e-mail and in person. An ex-con showed up one day, angry that a friend of his had been declared a dangerous offender thanks to Hare's checklist. Other characters have appeared in his lab doorway, looking in and saying nothing.
We immediately find ourselves discussing the criminal du jour, the jet-setting French con man Christophe Rocancourt, notorious for passing himself off as a member of the Rockefeller family, who has just been arrested in Victoria.
"I'd sure as hell like to have a close look at him," Hare muses.
Like every scientist, Hare likes a good puzzle, and that was reason enough to make a career out of psychopaths. "These were particularly interesting human beings," he says. "Everything about them seemed to be paradoxical. They could do things that a lot of other people could not do" -- lie, steal, rape, murder -- "but they looked perfectly normal, and when you talked to them they seemed okay. It was a puzzle. I thought I'd try and unravel it."
Hare arrived at UBC in 1963, intending to follow up his doctoral research on punishment. Certain prisoners, it was rumoured, didn't respond to punishment, and Hare went to the federal penitentiary in New Westminster, British Columbia, to find these extreme cases. (He found plenty. In his chilling 1993 book on psychopathy, Without Conscience: The Disturbing World of the Psychopaths Among Us, he quotes one specimen's memories: "[M]y mother, the most beautiful person in the world. She was strong, she worked hard to take care of four kids. A beautiful person. I started stealing her jewellery when I was in the fifth grade. You know, I never really knew the bitch -- we went our separate ways.")
For his first paper, now a classic, Hare had his subjects watch a countdown timer. When it reached zero, they got a "harmless but painful" electric shock while an electrode taped to their fingers measured perspiration. Normal people would start sweating as the countdown proceeded, nervously anticipating the shock. Psychopaths didn't sweat. They didn't fear punishment -- which, presumably, also holds true outside the laboratory. In Without Conscience, he quotes a psychopathic rapist explaining why he finds it hard to empathize with his victims: "They are frightened, right? But, you see, I don't really understand it. I've been frightened myself, and it wasn't unpleasant."
In another Hare study, groups of letters were flashed to volunteers. Some of them were nonsense, some formed real words. The subject's job was to press a button whenever he recognized a real word, while Hare recorded response time and brain activity. Non-psychopaths respond faster and display more brain activity when processing emotionally loaded words such as "rape" or "cancer" than when they see neutral words such as "tree." With psychopaths, Hare found no difference. To them, "rape" and "tree" have the same emotional impact -- none.
Hare made another intriguing discovery by observing the hand gestures (called beats) people make while speaking. Research has shown that such gestures do more than add visual emphasis to our words (many people gesture while they're on the telephone, for example); it seems they actually help our brains find words. That's why the frequency of beats increases when someone is having trouble finding words, or is speaking a second language instead of his or her mother tongue. In a 1991 paper, Hare and his colleagues reported that psychopaths, especially when talking about things they should find emotional, such as their families, produce a higher frequency of beats than normal people. It's as if emotional language is a second language -- a foreign language, in effect -- to the psychopath.
Three decades of these studies, by Hare and others, has confirmed that psychopaths' brains work differently from ours, especially when processing emotion and language. Hare once illustrated this for Nicole Kidman, who had invited him to Hollywood to help her prepare for a role as a psychopath in Malice. How, she wondered, could she show the audience there was something fundamentally wrong with her character?
"I said, 'Here's a scene that you can use,' " Hare says. " 'You're walking down a street and there's an accident. A car has hit a child in the crosswalk. A crowd of people gather round. You walk up, the child's lying on the ground and there's blood running all over the place. You get a little blood on your shoes and you look down and say, "Oh shit." You look over at the child, kind of interested, but you're not repelled or horrified. You're just interested. Then you look at the mother, and you're really fascinated by the mother, who's emoting, crying out, doing all these different things. After a few minutes you turn away and go back to your house. You go into the bathroom and practice mimicking the facial expressions of the mother.' " He then pauses and says, "That's the psychopath: somebody who doesn't understand what's going on emotionally, but understands that something important has happened."
Hare's research upset a lot of people. Until the psychopath came into focus, it was possible to believe that bad people were just good people with bad parents or childhood trauma and that, with care, you could talk them back into being good. Hare's research suggested that some people behaved badly even when there had been no early trauma. Moreover, since psychopaths' brains were in fundamental ways different from ours, talking them into being like us might not be easy. Indeed, to this day, no one has found a way to do so.
"Some of the things he was saying about these individuals, it was unheard of," says Dr. Steven Stein, a psychologist and ceo of Multi-Health Systems in Toronto, the publisher of the Psychopathy Checklist. "Nobody believed him thirty years ago, but Bob hasn't wavered, and now everyone's where he is. Everyone's come full circle, except a small group who believe it's bad upbringing, family poverty, those kinds of factors, even though scientific evidence has shown that's not the case. There are wealthy psychopaths who've done horrendous things, and they were brought up in wonderful families."
"There's still a lot of opposition -- some criminologists, sociologists, and psychologists don't like psychopathy at all," Hare says. "I can spend the entire day going through the literature -- it's overwhelming, and unless you're semi-brain-dead you're stunned by it -- but a lot of people come out of there and say, 'So what? Psychopathy is a mythological construct.' They have political and social agendas: 'People are inherently good,' they say. 'Just give them a hug, a puppy dog, and a musical instrument and they're all going to be okay.' "
If Hare sounds a little bitter, it's because a decade ago, Correctional Service of Canada asked him to design a treatment program for psychopaths, but just after he submitted the plan in 1992, there were personnel changes at the top of CSC. The new team had a different agenda, which Hare summarizes as, "We don't believe in the badness of people." His plan sank without a trace.
By the late 1970s, after fifteen years in the business, Bob Hare knew what he was looking for when it came to psychopaths. They exhibit a cluster of distinctive personality traits, the most significant of which is an utter lack of conscience. They also have huge egos, short tempers, and an appetite for excitement -- a dangerous mix. In a typical prison population, about 20 percent of the inmates satisfy the Hare definition of a psychopath, but they are responsible for over half of all violent crime.
The research community, Hare realized, lacked a standard definition. "I found that we were all talking a different language, we were on different diagnostic pages, and I decided that we had to have some common instrument," he says. "The PCL-R was really designed to make it easier to publish articles and to let journal editors and reviewers know what I meant by psychopathy."
The Psychopathy Checklist consists of a set of forms and a manual that describes in detail how to score a subject in twenty categories that define psychopathy. Is he (or, more rarely, she) glib and superficially charming, callous and without empathy? Does he have a grandiose sense of self worth, shallow emotions, a lack of remorse or guilt? Is he impulsive, irresponsible, promiscuous? Did he have behavioural problems early in life? The information for each category must be carefully drawn from documents such as court transcripts, police reports, psychologists' reports, and victim-impact statements, and not solely from an interview, since psychopaths are superb liars ("pathological lying" and "conning/manipulative" are PCL-R categories). A prisoner may claim to love his family, for example, while his records show no visits or phone calls.
For each item, assessors -- psychologists or psychiatrists -- assign a score of zero (the item doesn't apply), one (the item applies in some respects), or two (the item applies in most respects). The maximum possible score is forty, and the boundary for clinical psychopathy hovers around thirty. Last year, the average score for all incarcerated male offenders in North America was 23.3. Hare guesses his own score would be about four or five.
In 1980, Hare's initial checklist began circulating in the research community, and it quickly became the standard. At last count nearly 500 papers and 150 doctoral dissertations had been based on it.
It's also found practical applications in police-squad rooms. Soon after he delivered a keynote speech at a conference for homicide detectives and prosecuting attorneys in Seattle three years ago, Hare got a letter thanking him for helping solve a series of homicides. The police had a suspect nailed for a couple of murders, but believed he was responsible for others. They were using the usual strategy to get a confession, telling him, 'Think how much better you'll feel, think of the families left behind,' and so on. After they'd heard Hare speak they realized they were dealing with a psychopath, someone who could feel neither guilt nor sorrow. They changed their interrogation tactic to, "So you murdered a couple of prostitutes. That's minor-league compared to Bundy or Gacy." The appeal to the psychopath's grandiosity worked. He didn't just confess to his other crimes, he bragged about them.
The most startling finding to emerge from Hare's work is that the popular image of the psychopath as a remorseless, smiling killer -- Paul Bernardo, Clifford Olson, John Wayne Gacy -- while not wrong, is incomplete. Yes, almost all serial killers, and most of Canada's dangerous offenders, are psychopaths, but violent criminals are just a tiny fraction of the psychopaths around us. Hare estimates that 1 percent of the population -- 300,000 people in Canada -- are psychopaths.
He calls them "subclinical" psychopaths. They're the charming predators who, unable to form real emotional bonds, find and use vulnerable women for sex and money (and inevitably abandon them). They're the con men like Christophe Rocancourt, and they're the stockbrokers and promoters who caused Forbes magazine to call the Vancouver Stock Exchange (now part of the Canadian Venture Exchange) the scam capital of the world. (Hare has said that if he couldn't study psychopaths in prisons, the Vancouver Stock Exchange would have been his second choice.) A significant proportion of persistent wife beaters, and people who have unprotected sex despite carrying the AIDS virus, are psychopaths. Psychopaths can be found in legislatures, hospitals, and used-car lots. They're your neighbour, your boss, and your blind date. Because they have no conscience, they're natural predators. If you didn't have a conscience, you'd be one too.
Psychopaths love chaos and hate rules, so they're comfortable in the fast-moving modern corporation. Dr. Paul Babiak, an industrial-organizational psychologist based near New York City, is in the process of writing a book with Bob Hare called When Psychopaths Go to Work: Cons, Bullies and the Puppetmaster. The subtitle refers to the three broad classes of psychopaths Babiak has encountered in the workplace.
"The con man works one-on-one," says Babiak. "They'll go after a woman, marry her, take her money, then move on and marry someone else. The puppet master would manipulate somebody to get at someone else. This type is more powerful because they're hidden." Babiak says psychopaths have three motivations: thrill-seeking, the pathological desire to win, and the inclination to hurt people. "They'll jump on any opportunity that allows them to do those things," he says. "If something better comes along, they'll drop you and move on."
How can you tell if your boss is a psychopath? It's not easy, says Babiak. "They have traits similar to ideal leaders. You would expect an ideal leader to be narcissistic, self-centred, dominant, very assertive, maybe to the point of being aggressive. Those things can easily be mistaken for the aggression and bullying that a psychopath would demonstrate. The ability to get people to follow you is a leadership trait, but being charismatic to the point of manipulating people is a psychopathic trait. They can sometimes be confused."
Once inside a company, psychopaths can be hard to excise. Babiak tells of a salesperson and psychopath -- call him John -- who was performing badly but not suffering for it. John was managing his boss -- flattering him, taking him out for drinks, flying to his side when he was in trouble. In return, his boss covered for him by hiding John's poor performance. The arrangement lasted until John's boss was moved. When his replacement called John to task for his abysmal sales numbers, John was a step ahead.
He'd already gone to the company president with a set of facts he used to argue that his new boss, and not he, should be fired. But he made a crucial mistake. "It was actually stolen data," Babiak says. "The only way [John] could have obtained it would be for him to have gone into a file into which no one was supposed to go. That seemed to be enough, and he was fired rather than the boss. Even so, in the end, he walked out with a company car, a bag of money, and a good reference."
"A lot of white-collar criminals are psychopaths," says Bob Hare. "But they flourish because the characteristics that define the disorder are actually valued. When they get caught, what happens? A slap on the wrist, a six-month ban from trading, and don't give us the $100 million back. I've always looked at white-collar crime as being as bad or worse than some of the physically violent crimes that are committed."
The best way to protect the workplace is not to hire psychopaths in the first place. That means training interviewers so they're less likely to be manipulated and conned. It means checking resumés for lies and distortions, and it means following up references.
Paul Babiak says he's "not comfortable" with one researcher's estimate that one in ten executives is a psychopath, but he has noticed that they are attracted to positions of power. When he describes employees such as John to other executives, they know exactly whom he's talking about. "I was talking to a group of human-resources executives yesterday," says Babiak, "and every one of them said, you know, I think I've got somebody like that."
By now, you're probably thinking the same thing. The number of psychopaths in society is about the same as the number of schizophrenics, but unlike schizophrenics, psychopaths aren't loners. That means most of us have met or will meet one. Hare gets dozens of letters and e-mail messages every month from people who say they recognize someone they know while reading Without Conscience. They go on to describe a brother, a sister, a husband. " 'Please help my seventeen-year-old son. . . .' " Hare reads aloud from one such missive. "It's a heart-rending letter, but what can I do? I'm not a clinician. I have hundreds of these things, and some of them are thirty or forty pages long."
Hare's book opened my eyes, too. Reading it, I realized that I might have known a psychopath, Jonathan, at the computer company where I worked in London, England, over twenty years ago. He was charming and confident, and from the moment he arrived he was on excellent terms with the executive inner circle. Jonathan had big plans and promised me that I was a big part of them. One night when I was alone in the office, Jonathan appeared, accompanied by what anyone should have recognized as two prostitutes. "These are two high-ranking staff from the Ministry of Defence," he said without missing a beat. "We're going over the details of a contract, which I'm afraid is classified top secret. You'll have to leave the building." His voice and eyes were absolutely persuasive and I complied. A few weeks later Jonathan was arrested. He had embezzled tens of thousands of pounds from the small firm, used the company as a mailing address for a marijuana importing business he was running on the side, and robbed the apartment of the company's owner, who was letting him stay there temporarily.
Like everyone who has been suckered by a psychopath -- and Bob Hare includes himself and many of his graduate students (who have been trained to spot them) in that list -- I'm ashamed that I fell for Jonathan. But he was brilliant, charismatic, and audacious. He radiated money and power (though in fact he had neither), while his real self -- manipulative, lying, parasitic, and irresponsible -- was just far enough under his surface to be invisible. Or was it? Maybe I didn't know how to look, or maybe I didn't really want to.
I saw his name in the news again recently. "A con man tricked top sports car makers Lotus into lending him a £70,000 model . . . then stole it and drove 6,000 miles across Europe, a court heard," the story began.
Knowing Jonathan is probably a psychopath makes me feel better. It's an explanation.
But away from the workplace, back in the world of the criminally violent psychopath, Hare's checklist has become broadly known, so broadly known, in fact, that it is now a constant source of concern for him. "People are misusing it, and they're misusing it in really strange ways," Hare says. "There are lots of clinicians who don't even have a manual. All they've seen is an article with the twenty items -- promiscuity, impulsiveness, and so forth -- listed."
In court, assessments of the same person done by defence and prosecution "experts" have varied by as much as twenty points. Such drastic differences are almost certainly the result of bias or incompetence, since research on the PCL-R itself has shown it has high "inter-rater reliability" (consistent results when a subject is assessed by more than one qualified assessor). In one court case, it was used to label a thirteen-year-old a psychopath, even though the PCL-R test is only meant to be used to rate adults with criminal histories. The test should be administered only by mental-health professionals (like all such psychological instruments, it is only for sale to those with credentials), but a social worker once used the PCL-R in testimony in a death-penalty case -- not because she was qualified but because she thought it was "interesting."
It shouldn't be used in death-penalty cases at all, Hare says, but U.S. Federal District Courts have ruled it admissible because it meets scientific standards.
"Bob and others like myself are saying it doesn't meet the ethical standards," says Dr. Henry Richards, a psychopathy researcher at the University of Washington. "A psychological instrument and diagnosis should not be a determinant of whether someone gets the death sentence. That's more of an ethical and political decision."
And into the ethical and political realm -- the realm of extrapolation, of speculation, of opinion -- Hare will not step. He's been asked to be a guest on Oprah (twice), 60 Minutes, and Larry King Live. Oprah wanted him alongside a psychopath and his victim. "I said, 'This is a circus,' " Hare says. "I couldn't do that." 60 Minutes also wanted to "make it sexy" by throwing real live psychopaths into the mix. Larry King Live phoned him at home while O. J. Simpson was rolling down the freeway in his white Bronco. Hare says no every time (while his publisher gently weeps).
Even in his particular area, Hare is unfailingly circumspect. Asked if he thinks there will ever be a cure for psychopathy -- a drug, an operation -- Hare steps back and examines the question. "The psychopath will say 'A cure for what?' I don't feel comfortable calling it a disease. Much of their behaviour, even the neurobiological patterns we observe, could be because they're using different strategies to get around the world. These strategies don't have to involve faulty wiring, just different wiring."
Are these people qualitatively different from us? "I would think yes," says Hare. "Do they form a discrete taxon or category? I would say probably -- the evidence is suggesting that. But does this mean that's because they have a broken motor? I don't know. It could be a natural variation." True saints, completely selfless individuals, are rare and unnatural too, he points out, but we don't talk about their being diseased.
Psychopathy research is raising more questions than it can answer, and many of them are leading to moral and ethical quagmires. For example: the PCL-R has turned out to be the best single predictor of recidivism that has ever existed; an offender with a high PCL-R score is three or four times more likely to reoffend than someone with a low score. Should a high PCL-R score, then, be sufficient grounds for denying parole? Or perhaps a psychopathy test could be used to prevent crime by screening individuals or groups at high risk -- for example, when police get a frantic "My boyfriend says he'll kill me" call, or when a teacher reports a student threatening to commit violence. Should society institutionalize psychopaths, even if they haven't broken the law?
The United Kingdom, partly in response to the 1993 abduction and murder of two-year-old James Bulger by two ten-year-olds, and partly in response to PCL-R data, is in the process of creating a new legal classification called Dangerous and Severe Personality Disorder (DSPD). As it stands, the government proposes to allow authorities to detain people declared DSPD, even if they have not committed a crime. (Sample text from one of the Web sites that have sprung up in response: "I was diagnosed with an untreatable personality disorder by a doctor who saw me for ten minutes, he later claimed I was a psychopath. . . . Please don't let them do this to me; don't let them do it to anybody. I'm not a danger to the public, nor are most mentally ill people.")
Hare is a consultant on the DSPD project, and finds the potential for abuse of power horrifying. So do scientists such as Dr. Richard Tees, head of psychology at UBC, a colleague of Hare's since 1965. "I am concerned about our political masters deciding that the PCL-R is the silver bullet that's going to fix everything," he says. "We'll let people out [of prison] on the basis of scores on this, and we'll put them in. And we'll take children who do badly on some version of this and segregate them or something. It wasn't designed to do any of these things. The problems that politicians are trying to solve are fundamentally more complicated than the one that Bob has solved."
So many of these awkward questions would vanish if only there were a functioning treatment program for psychopathy. But there isn't. In fact, several studies have shown that existing treatment makes criminal psychopaths worse. In one, psychopaths who underwent social-skills and anger-management training before release had an 82 percent reconviction rate. Psychopaths who didn't take the program had a 59 percent reconviction rate. Conventional psychotherapy starts with the assumption that a patient wants to change, but psychopaths are usually perfectly happy as they are. They enrol in such programs to improve their chances of parole. "These guys learn the words but not the music," Hare says. "They can repeat all the psychiatric jargon -- 'I feel remorse,' they talk about the offence cycle -- but these are words, hollow words."
Hare has co-developed a new treatment program specifically for violent psychopaths, using what he knows about the psychopathic personality. The idea is to encourage them to be better by appealing not to their (non-existent) altruism but to their (abundant) self-interest.
"It's not designed to change personality, but to modify behaviour by, among other things, convincing them that there are ways they can get what they want without harming others," Hare explains. The program will try to make them understand that violence is bad, not for society, but for the psychopath himself. (Look where it got you: jail.) A similar program will soon be put in place for psychopathic offenders in the UK.
"The irony is that Canada could have had this all set up and they could have been leaders in the world. But they dropped the ball completely," Hare says, referring to his decade-old treatment proposal, sitting on a shelf somewhere within Corrections Canada.
Even if Hare's treatment program works, it will only address the violent minority of psychopaths. What about the majority, the subclinical psychopaths milling all around us? At the moment, the only thing Hare and his colleagues can offer is self-protection through self-education. Know your own weaknesses, they advise, because the psychopath will find and use them. Learn to recognize the psychopath, they tell us, before adding that even experts are regularly taken in.
After thirty-five years of work, Bob Hare has brought us to the stage where we know what psychopathy is, how much damage psychopaths do, and even how to identify them. But we don't know how to treat them or protect the population from them. The real work is just beginning. Solving the puzzle of the psychopath is an invigorating prospect -- if you're a scientist. Perhaps the rest of us can be forgiven for our impatience to see the whole thing come to an end.
Source (http://www.hare.org/links/saturday.html)