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.

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