Psychopathy/Forensic and clinical aspects

Psychopathy/Forensic and clinical aspects  (personality disorder,  character disturbance)

For the clinical definition, traits must be differentiated from habits and behaviors. Traits are 'hard-wired' and resistant to change. This does not mean that they are purely genetically determined; but they may have roots in genetic predispositions and are therefor deeply ingrained.

Psychopaths have chosen a criminal way of live (Samenow), thinking and predation, be it channeled as in sociopathy or in a more crude and arrestable way. It is moderated by temperamental and constitutional factors like high aggression, low empathy and sometimes suggestibility and ease of dissociation. A key element is predatory aggression as opposed to reactive aggression, they are intraspecies prediators . Predatory or instrumental aggression is cold and goal oriented with little or no empathy involved. Research originated from cats and how cats feel and react when they prey. Psychopaths view other humans much like a cat views a mouse - prey to be eaten and this mode of relating can be incredibly intense (i.e. psychopathic stare).

Psychopaths often survived a neglectful childhood and other interpersonal trauma, but the great number of false positives suggests that what matters is how they choose to react to those hardships. They refuse to internalize psychic models from healthy, supportive peers and instead identify with aggressive, sadistic caretakers (primary objects) which do not get integrated in a whole self concept. This fragmentation and part object world is used for deception later on in a chameleon-like fashion, enforced by envy-centered egocentric thinking and brutal aggression.

Behaviorally, from a DSM point of view, psychopaths show a mix of histrionic, borderline, narcissistic and antisocial personality disorders plus additional paranoid and schizoid features (thinking borders on delusion and transient psychosis are frequently observed). They can tell right from wrong, they "already see, they disagree." (G. Simon)

Biological motivational systems are fused and impulse driven, especially sexual, aggressive and attachment systems; reptilian residues might take over. Relations to others are defined by a power paradigm, so that sexual and attachment needs are perverted to control and subdue others. Sadomasochistic pleasures self-enforce damaging and antisocial actions and dominate a consistent pattern rationalization and denial.

Antisocial personality disorder

Psychopathy should not be confused with antisocial personality disorder, although these conditions overlap; the former is a largely personality-based condition, the latter a largely behavior-based condition.

Genetic influence

It is now understood that psychopathy is a spectrum ranging from normal to severely disturbed, not merely a genetic switch and that constitutional and environmental (learned) factors interact in a process, which is self enforcing via sadistic pleasure derived from deception, a psychopathic emotion called contemptuous delight. Meta-­analyses reveal considerable (29–56%) genetic influence on psychopathic traits, although they leave unanswered the exact nature of this influ­ence, i.e. how these genes get activated when 44-71% of children with this predisposition do not develop these traits. These findings underscore the importance of learning and free will in human development.

Devaluation and Deception

Psychopaths devalue other people to bolster their pathological grandiose self. They feel even more contemptuous delight if this devaluation is covert, manipulating the mark into harming them self.

"I am only trying to help you (ITHY)" is a mind game described by Berne , when people have covert selfish motives underlying the offer to "help". Benign motives include social agency workers, hospitals, etc needing people to justify their budged; on the other end of the spectrum are black angel nurses, educational workers deriving secret pleasures from "necessary" punishments, doctors colluding with Munchausen patients and social control, even warfare disguised as "protection" and solicitousness.

Psychopaths may offer "gifts" which turn out to be rather annoying or rubbish - devaluing the mark - while playing the servant all along and expecting a great deal of gratitude in return. (Face masks and vaccines come to mind).

Projective pseudo-identification

Psychopaths engage in a special type of projection, a malignant type of dramatization, called projective pseudo-identification by Meloy. It has more in common with brainwashing or mind control techniques, which seems to come quite natural to them: it follows from deception (a core trait) and their wish for omnipotent control of their victims - they want others to accept their will as their own (which is a core definition of mind control).

The term pseudo is important: first, they "project" feelings onto others (i.e. anxiety) which they them selves do not have. They see anxiety as a weakness and as others are devalued they must - by definition, so to speak - possess devalued attributes. Second, the grandiose egocentricity encompasses the whole universe as part of their "self". Other people are possessed objects of this inner grandiose universe. It follows that projection for the psychopath is not externalization (as the concept of defense mechanism implies) but dramatization, staging, production, orchestration of his inner world.

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