Confessions of a Sociopath by M.E. Thomas Read Free Book Online Page B

“identifying” sociopaths, as opposed to diagnosing. The message seems clear: These people
are
sociopaths, they aren’t people who have sociopathy. Diagnosis is for people for whom there is a treatment. Because there is no known effective treatment for sociopaths, there is just the question of what to do with the sociopath problem. In
Blade Runner
, society had come to a definitive decision of what fate would befall its empathy-free creations.
    The sociopath problem for our society is, how do we keep sociopaths from acting in antisocial ways? Before society can even begin to discuss solutions to that problem, they need a reliable way to identify sociopaths. Before psychologists canidentify them, however, they must be able to understand them. And to be able to understand them, they must be able to identify them. One psychologist has illustrated the tautology in the following way: “Why has this man done these terrible things? Because he is a psychopath. And how do you know that he is a psychopath? Because he has done these terrible things.”
    It’s a classic chicken-and-egg dilemma that has prompted countless criticisms of the most popular diagnostic criteria. All diagnostic tools are based on the observable traits of people who have been diagnosed as sociopaths, which, apart from being rather circular, introduces the risk of biases that might skew which traits get included or not included. Of course there must be some starting place. Cleckley and others observed that some traits occurred more commonly in his patients than in the general populace. Once that recurring group of traits had a name, researchers could try to figure out if they all had a common cause, if they were related to other identifiable groups of traits, how many people had that group of traits, and what kinds of things those people got up to compared to the larger population. But Cleckley was well aware that his checklist was just his own poor approximation of the essence of sociopathy, and consequently was not infallible or even all-inclusive—a humility that I sometimes feel is lacking with researchers of sociopathy.
    The current primary tool for identifying psychopaths (and, by association, sociopaths) is the PCL-R (Psychopathy Checklist–Revised), developed by Dr. Robert D. Hare, professor emeritus of forensic psychology at the University of British Columbia and generally considered the primary authority on criminal psychopathy. “Science cannot progress without reliable and accurate measurement of what it is you are trying to study,” Hare explains. With a research assistant he compiled alist of twenty traits that he noticed recurring among the prison population he was studying: lack of empathy and remorse, megalomania, manipulation, charm, self-interestedness, impulsivity, proficiency at lying, along with criminal-specific traits such as juvenile delinquency, revocation of conditional release, and criminal versatility. He instructed other psychologists giving the assessment to award two points if a trait was present, one if they were unsure or it applied somewhat, and zero if it wasn’t. The test was reliable, in that repeat assessments resulted in approximately the same score, but its validity has been heavily criticized.
    Validity is a measure of how well a diagnostic tests what it is meant to test—in this situation, how accurately the PCL-R identifies psychopaths. The PCL-R has been criticized for being exclusively based on the prison population. Hare himself has admitted that it was done solely for convenience: “Prisoners are easy. They like meeting researchers. It breaks up the monotony of their day. But CEOs, politicians …” In a widely publicized scandal, Hare threatened to sue two psychologists who warned in a paper that the checklist was increasingly being mistaken for a complete definition of psychopathy, which is a broader personality construct that includes deceitfulness, impulsivity, and recklessness, but not necessarily