Without Conscience

by Robert D. Hare

  A HISTORICAL VIEW

  One of the first clinicians to write about psychopaths was Philippe Pinel, an early nineteenth-century French psychiatrist. He used the term insanity without delirium to describe a pattern of behavior marked by utter remorselessness and a complete lack of restraint, a pattern he considered distinct from the ordinary “evil that men do.”4

  Pinel regarded this condition morally neutral, but other writers considered these patients “morally insane,” the very embodiment of evil. So began an argument that spanned generations and that seesawed between the view that psychopaths were “mad” and that they were “bad” or even diabolical.

  THE DIRTY DOZEN is a classic movie that glorifies a longstanding Hollywood myth: Turn a psychopath inside out and you find a hero. The plot of the movie concerns a choice given to a handful of the roughest, toughest criminals: volunteer for what amounts to a suicide mission, or stay in prison. The task involves the capture of a castle in which the elite command of the German army is ensconced. Needless to say, the Dirty Dozen succeed in the capture. And needless to say, they are honored as heroes, to the apparent gratification of several generations of audiences.

  Psychiatrist James Weiss, author of All But Me and Thee, tells a very different tale. His book recounts an investigation conducted during World War II by Brigadier General Elliot D. Cook and his assistant, Colonel Ralph Bing. They started at the end point—the Army East Coast Processing (Detention) Center at Camp Edwards on Cape Cod—and worked backward to company level to determine how the more than two thousand inmates had wound up there.

  The story, as Weiss remarks, was “the same sad tale” told over and over again. Knowing the company was going into a fight, the soldier volunteered to go back for supplies and was never heard from again. Or the soldier went from stealing food to stealing a truck, and totaling it on a joyride. Completely unresponsive to interests of their fellow GIs and more attuned to instant gratification than to the fundamental rules of caution in combat, these fellows had a much greater chance of getting shot—“Peterson ... stuck his head up when everyone else had theirs down and a German sniper put a bullet through the middle of it”—than of accomplishing an act of heroism that involved planning, cunning, and actions rooted in conscience.

  The Dirty Dozen might look squeaky clean by the time Hollywood gets through with them, but in real life, as Weiss concludes, “conversion by combat seldom if ever happens.” (James Weiss, Journal of Operational Psychiatry 5, 1974, 119.)

  World War II gave the debate a new, practical urgency—more than speculation was necessary. First, with the military draft, the need became pressing to identify, diagnose, and if possible treat individuals who could disrupt or even destroy strict military control, and this issue drew lively public attention. But an even more ominous significance arose with the revelation of the Nazis’ machinery of destruction and their cold-blooded program of extermination. What were the dynamics of such a development? How and why could individuals—even, terrifyingly, one individual in command of a nation—operate outside the rules that most people accepted as restraints on their basest impulses and fantasies?

  Many writers took up the challenge, but none had as great an impact as Hervey Cleckley. In his now classic book, The Mask of Sanity, first published in 1941,5 Cleckley pleaded for attention to what he recognized as a dire but ignored social problem. He wrote dramatically about his patients and provided the general public with the first detailed view of psychopathy. For example, in his book he included his case notes on Gregory, a young man with a yards-long arrest sheet who had failed to kill his mother only because of a malfunctioning gun.

  It would be impossible to describe adequately this young man’s career without writing hundreds of pages. His repeated antisocial acts and the triviality of his apparent motivation as well as his inability to learn by experience to make a better adjustment and avoid serious trouble that can be readily foreseen, all make me feel that he is a classic example of psychopathic personality. I think it very likely that he will continue to behave as he has behaved in the past, and I do not know of any psychiatric treatment that is likely to influence this behavior appreciably or to help him make a better adjustment, (pp. 173-74)

  Phrases such as “shrewdness and agility of mind,” “talks entertainingly,” and “exceptional charm” dot Cleckley’s case histories. He noted that a psychopath in jail or prison would use his considerable social skills to persuade a judge that he actually belonged in a mental hospital. Once in the hospital, where nobody wanted him—because he was too disruptive—he would apply his skills to obtaining a release.

  Interspersed in his vivid clinical descriptions are Cleckley’s own meditations on the meaning of the psychopath’s behavior.

  The [psychopath] is unfamiliar with the primary facts or data of what might be called personal values and is altogether incapable of understanding such matters. It is impossible for him to take even a slight interest in the tragedy or joy or the striving of humanity as presented in serious literature or art. He is also indifferent to all these matters in life itself. Beauty and ugliness, except in a very superficial sense, goodness, evil, love, horror, and humor have no actual meaning, no power to move him. He is, furthermore, lacking in the ability to see that others are moved. It is as though he were color-blind, despite his sharp intelligence, to this aspect of human existence. It cannot be explained to him because there is nothing in his orbit of awareness that can bridge the gap with comparison. He can repeat the words and say glibly that he understands, and there is no way for him to realize that he does not understand (p. 90)

  The Mask of Sanity greatly influenced researchers in the United States and Canada and is the clinical framework for much of the scientific research on psychopathy conducted in the past quarter-century. For the most part, the goal of this research has been to find out what makes the psychopath “tick.” We now have some important clues, which are described throughout this book. But as our knowledge of the devastation caused by psychopaths at large in society increases, modern research has an even more vital goal—the development of reliable ways to identify these individuals in order to minimize the risk they pose to others. This task is of immense importance to the general public and individuals alike. My role in the search began in the 1960s at the psychology department of the University of British Columbia. There, my growing interest in psychopathy merged with my prison experience to form what was to become my life work. Where once I had worked I managed to continue my research.

  IDENTIFYING

  “TRUE PSYCHOPATHS”

  A problem in doing research in prisons is that the inmates generally are suspicious and mistrustful of outsiders, particularly academics. I was helped by an inmate at the top of the prison hierarchy who concluded that my research would have no negative consequences for those who participated and that it might even be of some use in understanding criminal behavior. This inmate, a professional bank robber, became my spokesman, endorsing my work and spreading the word that he himself was a willing participant. The result was a great surge of volunteers, an embarrassment of riches that brought with it its own problem: How was I to distinguish the “true” psychopaths from the rest of the volunteers?

  In the 1960s psychologists and psychiatrists were by no means in complete agreement on what distinguished the psychopath. The problem of classification was a major stumbling block. We were attempting to sort human beings, not apples and oranges, and the distinguishing features we were concerned with were psychological phenomena, well hidden from the probing eye of science.

  A WOMAN IN Florida bought him a new car.

  A woman in California bought him a motor home.

  Who knows who else bought him what else.

  As a newspaper article describing Leslie Gall’s cross country exploits aptly pointed out, it’s all in the name: Gall says it all.

  The “sweetheart swindler,” as one of his victims referred to him, made his way from widow to widow, bilking them out of all
he needed and far more. They opened their hearts and their checkbooks to him. “With nerve, charm, and a suitcase full of false IDs, he allegedly stole tens of thousands of dollars from elderly women he met at senior citizens’ dances and social clubs. In looking into his background, California police found a lengthy criminal record, all related to fraud, forgery, and theft.

  When Gall learned that the California police were on his trail, he had his lawyer write a letter to police in Florida saying that he was willing to turn himself in in exchange for a guarantee that he could do his time in a Canadian prison.

  “Since the story was made public,” wrote reporter Dale Brazao, California police phones were “ringing constantly with calls from people saying they think Gall may have also been involved with their mother or an aunt. ‘He’s got that 1-think-l-know-that-guy kind of a face.... Who knows how many more victims will come forward.”

  Now serving a ten-year sentence in a Florida prison, Gall portrays himself as a humanitarian. “Sure I took their money, but they got their money’s worth out of me,” he said. “I fulfilled their need. They got attention, affection, companionship, and, in some cases, they got love.... There were times we didn’t even get out of bed.” (Based on articles by Dale Brazao, Toronto Star, May 19, 1990, and April 20, 1992.)

  I might have used standard psychological tests to identify psychopathic inmates, but most of those tests depended on self-reporting—for example, “I lie (1) easily; (2) with some difficulty; (3) never.” The inmate population I was working with was quite adept at figuring out what psychiatrists and psychologists were trying to get at when they used tests and interviews. Generally, they saw no reason to reveal anything of real significance to prison staff members but every reason to show themselves to the best advantage with respect to possible parole, change of work assignment, admission to some program or other, and so forth. Moreover, the psychopaths among them were expert at distorting and molding the truth to suit their purposes. Impression management was definitely one of their strong suits.

  As a result, the prison records were often filled with carefully written personality profiles that seemed embarrassingly at odds with what everyone else in the prison knew about the inmates in question. I recall one file in which the psychologist had used a battery of self-report tests to conclude that a callous killer was actually a sensitive, caring individual who needed only the psychological equivalent of a warm hug! Because of the uncritical use of personality tests, the literature was (and still is) cluttered with studies that purported to be about psychopathy but actually had very little to do with it.

  One inmate provided a great example of why I was reluctant to rely on psychological tests. During the course of an interview with him in one of my research projects, the topic of psychological tests came up. He told me that he knew all about them, particularly about the self-report inventory most popular with prison psychologists, the Minnesota Multiphasic Personality Inventory, or MMPI. As it turned out, this fellow had in his cell a complete set of question booklets, scoring sheets, scoring templates, and interpretive manuals for the MMPI. He used this material, and the expertise it gave him, to provide a consulting service for other inmates—for a fee, of course. He would determine what sort of profile his client should have, given his circumstances and objectives, and then coach him on how to answer the questions.

  “Just arrived in the prison? What you want to show is that you’re a bit disturbed, perhaps depressed and anxious, but not disturbed in such a way that you can’t be treated. When you’re close to a parole date come and see me again, and we’ll arrange for you to show significant improvement.”

  Even without such “professional” help, many criminals are able to fake the results of psychological tests without too much difficulty. Recently, an inmate in one of my research projects had an institutional file that contained three completely different MMPI profiles. Obtained about a year apart, the first suggested that the man was psychotic, the second that he was perfectly normal, and the third that he was mildly disturbed. During our interview he offered the opinion that psychologists and psychiatrists were “air heads” who believed anything he told them. He said he had faked mental illness on the first test in order to receive a transfer to the psychiatric unit of the prison, where he thought he could do “easy time.” On finding that the unit was not to his liking (“too many buggy cons”) he managed to take another MMPI, this time coming out normal, and was moved back to the main prison. Soon afterward, he decided to portray himself as anxious and depressed, and produced an MMPI profile suggestive of mild disturbance, whereupon he was given Valium, which he sold to other inmates. The irony here is that the prison psychologist treated each of the three MMPI profiles as valid indications of the type and degree of psychiatric disturbance suffered by the inmate.

  I decided to grapple with the classification problem by not relying solely on self-reporting. To gather my data, I assembled a team of clinicians who were thoroughly familiar with Cleckley’s work. They would identify psychopaths for study in the prison population by means of long, detailed interviews and close study of file information. I provided these “raters” with Cleckley’s list of the characteristics of psychopathy to serve as a guideline. As it turned out, agreement among the clinicians was generally very high; the few disagreements that arose were resolved by discussion.

  Still, other researchers and clinicians were never certain about just how we made our diagnoses. Therefore, my students and I spent more than ten years improving and refining our procedures for ferreting the psychopaths out of the general prison population. The result was a highly reliable diagnostic tool that any clinician or researcher could use and that yielded a richly detailed profile of the personality disorder called psychopathy. We named this instrument the Psychopathy Checklist. 6 For the first time, a generally accepted, scientifically sound means of measuring and diagnosing psychopathy became available. The Psychopathy Checklist is now used worldwide to help clinicians and researchers distinguish with reasonable certainty true psychopaths from those who merely break the rules.

  Chapter 3

  The Profile:

  Feelings and

  Relationships

  Do I care about other people? That’s a tough one. But, yeah, I guess I really do ... but I don’t let my feelings get in the way.... I mean, I’m as warm and caring as the next guy, but let’s face it, everyone’s trying to screw you.... You’ve got to look out for yourself, park your feelings. Say you need something, or someone messes with you ... maybe tries to rip you off... you take care of it ... do whatever needs to be done.... Do I feel bad if I have to hurt someone? Yeah, sometimes. But mostly it’s like ... uh ... [laughs] ... how did you feel the last time you squashed a bug?

  —A psychopath doing time for kidnapping, rape, and extortion

  The Psychopathy Checklist lets us discuss psychopaths with little risk that we are describing simple social deviance or criminality, or that we are mislabeling people who have nothing more in common than that they have broken the law. But it also provides a detailed picture of the disordered personalities of the psychopaths among us. In this chapter and the next I bring that picture into focus by describing the more salient features one by one. This chapter looks at the emotional and interpersonal traits of this complex personality disorder; chapter 4 examines the unstable, characteristically antisocial lifestyle of the psychopath.

  Key Symptoms of Psychopathy

  Emotional/Interpersonal Social Deviance

  • glib and superficial • impulsive

  • egocentric and grandiose • poor behavior controls

  • lack of remorse or guilt • need for excitement

  • lack of empathy • lack of responsibility

  • deceitful and manipulative • early behavior problems

  • shallow emotions • adult antisocial behavior

  A CAUTIONARY NOTE

  The Psychopathy Checklist is a complex clinical tool for professional use.1 What follows is a general s
ummary of the key traits and behaviors of psychopaths. Do not use these symptoms to diagnose yourself or others. A diagnosis requires explicit training and access to the formal scoring manual. If you suspect that someone you know conforms to the profile described here and in the next chapter, and if it is important to you to obtain an expert opinion, seek the services of a qualified (registered) forensic psychologist or psychiatrist.

  Also, be aware that people who are not psychopaths may have some of the symptoms described here. Many people are impulsive, or glib, or cold and unfeeling, or antisocial, but this does not mean they are psychopaths. Psychopathy is a syndrome—a cluster of related symptoms.

  GLIB AND SUPERFICIAL

  Psychopaths are often witty and articulate. They can be amusing and entertaining conversationalists, ready with a quick and clever comeback, and can tell unlikely but convincing stories that cast themselves in a good light. They can be very effective in presenting themselves well and are often very likable and charming. To some people, however, they seem too slick and smooth, too obviously insincere and superficial. Astute observers often get the impression that psychopaths are play-acting, mechanically “reading their lines.”