October 1, 2008

Psychopathy, Antisocial Personality Disorder, and Narcissism

Updated 12 years later.


A 1996 editorial by Robert Hare, who is the most prominent researcher on psychopathy, even inventing a diagnostic checklist which for complex reasons he named the Hare Psychopathy Checklist.

The article explains the difference between psychopathy and antisocial personality disorder.

He writes that in 1980 with DSM III, psychopathy was relabeled as antisocial personality disorder.   While they still referred to the same individual, it was the approach that was different.  This wasn't just a name change,  it was a paradigm shift: instead of describing personality characteristics, it focused on behaviors.  Not nouns, but gerunds.

Psychopathy: egocentricity, deceit, shallow affect, manipulativeness, selfishness, and lack of empathy, guilt or remorse

Antisocial Personality Disorder: persistent violations of social norms, including lying, stealing, truancy, inconsistent work behavior and traffic arrests

That this happens in 1980 makes sense, coming at a time where "people are not bad, behaviors are."

Interestingly, Hare is mostly concerned that this relabeling will mean psychopathy will be overdiagnosed.  His reasoning is that APD is a broader classification-, and few of these are actually psychopaths.   But once the "diagnosis" of APD is made, clinicians and lawyers may overgeneralize and call them psychopaths.

It matters.  As Hare points out, psychopathy is considered an aggravating, not mitigating factor  in a crime (opposite to, say, bipolar.)  Psychopaths are evil and will do it again, so throw the book at them.

That was 1996.

Anyone who has read more than one post on this blog knows where I'm going: What Hare had labeled psychopathy sounds a lot like narcissism.

A glance at the above description supports this, but there are three important differences.

Identity:   The narcissist has identity-- but it is one he chose, not one that evolved naturally.  That means he thinks of himself as something-- based on a model.  He consciously identifies with someone-- Tony Soprano, the guy from Coldplay, Jack Kerouac, or a combination of traits from people, etc. 

The psychopath has no model-- he just exists.

Since the narcissist's identity is entirely made up, it requires other people for constant reaffirmation of his identity and of its value.  Psychopaths don't need people for this, they need them for material things.

Ability to feel:

Psychopathy is characterized by a lack of feeling and empathy-- a lack.  When he kills you, he does not feel remorse, or fear--  after the immediate emotions, he doesn't feel anything. The next day is the same as the previous day. 

"Narcissists, whatever their faults, feel deeply, too deeply.  That's why they take rejection so hard."

No. Narcissists appear to have emotions, feelings, empathy-- they cry, laugh, feel your pain, etc-- but none of this is real.  They don't feel it.  It's not linked to anything internal.  They're crying at the funeral, for sure, but on the inside they're wondering why it doesn't hurt as much as they think it should.  They're proud at their daughter's ballet recital, but not actually proud, inside they're wondering about their promotion, or that jerk at the store, etc.  He may feel pride that she's his daughter, but not empathy, nothing about her as a separate person.

Sometimes even they believe the emotion is real.  If you've decided you're The Godfather, then those are the emotions you're going to experience or not experience, with the same intensities.  Pride matters, lust won't.  Etc.

And don't get confused.  Narcissists don't pick their identity based on their genetic or preset emotional range; the choosing of the identity comes first.  Picking who you are actually changes how you feel, how you think. 

A narcissist is a psychopath who has assimialted the emotions of the character he is playing.

Narcissists don't feel guilt-- based on objective right and wrong-- they feel shame-- based on exposure.  When they get caught, they're answer is always the same: "wait, that's not really who I am..."

The only thing narcissists truly feel is the pain of narcissistic injury, and rage.

Potential for violence:

The technical distinction is how psychopaths or narcissists internalize these aggressive or libidinal forces.  Both feel aggression, but the narcissist takes that aggression and makes it a part of who he is: I am aggressive, I am an aggressor.  The psychopath lacks a properly defined ego.  He's not an aggressor; aggression is simply an as needed tool, a means to an end.

For the narcissist, violence is a volitional expression of rage, or the response to a narcissistic injury.  If he doesn't get the affirmation he needs; if something threatens his identity, then he attacks.

The psychopath is utilitarian:  I needed a burger, you had it, so I stabbed you in the throat.  Whatever.

As bad as that sounds, here's the narcissist's discourse on the same crime: I needed a burger, you had it, so I stabbed you in the throat.  But wait, that's not the whole story, listen,  what I did was justified because...


Someone is going to try and correct me, that what I am actually describing is Kernberg's malignant narcissism, and not NPD, or even "run of the mill" narcissism, which are not associated with violence.

And that would be wrong, which is the whole point.  There is no difference between the three, it's all the same, what's different is the execution, not the potential.

There is a limitless, catastrophic potential for violence.  That it rarely manifests is exclusively due to circumstances, not internal self controls.  He's the married man of 20 years who suddenly needs to stab his daughter 10 times because of something that hurt his pride.

It's the guy who goes to happy hour, then is about to get pulled over for a speeding ticket but is afraid of a DUI so he drives off.  During the high speed pursuit he accidentally hits a kid on a bike, but instead of stopping decides now he really has to get away or else he's going to jail, so he drives even faster.  Then he tries to run on foot and hide in a building, but-- surprise-- there's some woman there, so now he has to take her hostage because she's seen his face...

The psychopath does all those things because at each moment, that's his only option.  The narcissist does them because he's "actually a good person, this stuff is just an aberration, if I can just get away I'll be back to being a valuable person again..."   

And you may be tempted to blame the alcohol he had at happy hour.  And that would be wrong.

Two kinds of violence: a means of protecting the identity from exposure or harm, or the result of rage from the identity being exposed or harmed.

You say: my narcissist never ran from the cops, he never killed his daughter.  But that's because your narcissist had at that moment other ways of dealing with the problem.    It's the potential for violence.

All narcissists have this potential, it is intrinsic to the personality structure, which is defined as "me above all things."  Sure, usually they figure out non-violent ways to live their life, but that potential is there.

The reason a psychopath kills is because he is bad.  The reason a narcissist kills is so that no one finds out he is bad.