The Psychology of Wickedness
Psychopathy and Sadism
On occasion one writes a paper that instills a sense of pride, even years later. This is mine. It appeared in a thematic collection of papers on “wickedness” edited by Ansar Haroun in Psychiatric Annals in 1997. Although morality is outside the paradigm of psychology, psychiatry, and psychoanalysis, the psychodynamics of the psychopath and the sadist, often causing fear and anger in others, stimulate a reactive countertransference to idealize or condemn—evoking the literary stature of the Marquis de Sade or the mythic evil of Charlie Manson. Moralizing about psychopathy is an ever-present potential contaminant of scientific research on psychopathy, especially since the principal impairment in psychopaths is one of empathic judgment. Can we think objectively about a clinical problem that by its very nature is partially defined by community morals?
Since I come from a long line of Presbyterian ministers and have myself earned a graduate degree in theology, I approach the question of wickedness in psychology with an abundance of curiosity, but perhaps an insufficiency of humility. For wickedness, or evil, is outside the paradigm of science and, I think, should remain so. It is, instead, the default of morality, or moral choice, and occupies the paradoxical position of being known to the science of psychology yet not of it.
In the clinical practice of psychiatry and psychology, moreover, we cannot avoid occasionally coming face to face with patients who stimulate in us the thought that they are mean, wicked, or in some cases ra, the Hebrew for evil. Such patients live, in Oscar Wilde’s words, “to give rebellion its fascination, and disobedience its charm,” and truly frighten us as clinicians. Fortunately, their numbers appear to be few, since we have now entered the diagnostic and psychodynamic landscape of the evildoers, the wicked ones, in psychology: psychopaths and sadists. If we think about the psychology of wickedness, these are the men we must study and understand, yet fear.
The construct “psychopathy” was disavowed with the publication of DSM-II (American Psychiatric Association, 1968) but regained a tenuous foothold in DSM-IV (American Psychiatric Association, 1994). Subsumed by the psychodiagnosis of antisocial personality disorder, it is a much older and more clinically complex term that originated in late 19th-century German psychiatry, wherein such a patient would have been labeled a “constitutional psychopathic inferior,” a phrase that interweaves both the Lombrosian notion of a bad seed and the common moral judgment that such people are less than human (Meloy, 1988). A century later, a substantial and growing body of research argues that habitual criminality does, in fact, have a heritable genetic loading (Raine, 1993).
Following the classic and resurrective work of Cleckley (1941), psychopathy has been carefully and empirically defined by Hare (Harpur, Hakstian, and Hare, 1988) as a constellation of traits and behaviors characterized by two factors: a callous and remorseless disregard for the rights and feelings of others and a pattern of chronic antisocial behavior. This two-factor loading can be reliably assessed using the 20-item Psychopathy Checklist–Revised (Hare, 1991). Such an assessment requires both a clinical interview and scrutiny of independent historical data because of the mendacity of such patients. At a certain quantitative threshold, the severe psychopath can be clinically identified, and predictive validity studies indicate that the construct is not useless psychobabble. Psychopaths are not amenable to treatment (Meloy, 1995) and in one study were found to be more violent 10 years after immersion in a therapeutic community before release (Rice, Harris, and Cormier, 1992). They are also more dangerous than other criminals and habitually engage in predatory, rather than affective violence (Serin, 1991). The former refers to planned, purposeful, and emotionless violence, usually toward strangers. The latter describes the reactive, emotional, and defensive violence that is the commonplace hurtful aggression that most male members of our species act out, on occasion. Usually the victims and the perpetrators of affective violence are bonded to some degree (Meloy, 1992). In maximum-security prisons, approximately three fourths of inmates will meet the criteria for antisocial personality disorder (DSM-IV), but at most only one third will be psychopaths (Hare, Hart, and Harpur, 1991).
Some of the psychodynamics of the psychopath bring us closer to his evil, or his wish to destroy goodness. Psychopaths are aggressively narcissistic, and this aspect of their character pathology is often behaviorally expressed in their repetitive devaluation of others, not just in fantasy, as we see in narcissistic personality disorder, but in real life. The psychopath generally does this for two reasons: first, to maintain his grandiosity, or sense of being larger than life; and second, to repair perceived insults or emotional wounds by retaliating against those he holds responsible. This repetitive devaluation of others, which may range from verbal insults to serial homicide, also serves to diminish envy, an emotion highlighted by Klein (1975) and later explored by Berke (1988). Envy is the wish to possess the goodness perceived in others. And, if it cannot be possessed, destruction of the good object renders it not worth having. This theorizing may, at first blush, seem quite theoretical, but not if we imagine a very empathic and loving psychotherapist who extends her caring—and perhaps violates her own professional boundaries—to help a psychopathic patient. Her perceived goodness may, in fact, stimulate the patient’s envy and place her in great danger, both emotionally and physically. Psychotherapists particularly at risk are those who narcissistically invest (take great pride) in their capacity to heal others or love others unconditionally. They consequently engage in counterphobic denial of real danger (Lion and Leaff, 1973): for instance, the psychiatrist who sees a psychopathic patient in his home office or at unusually late clinic hours when no other staff are around to accommodate the patient’s schedule.
Another psychodynamic of psychopathy that contributes to his evil propensities is his chronic emotional detachment from others (Gacono and Meloy, 1991). The psychopath’s relationships are defined by power gradients, not affectional ties. This biologically based deficit in bonding capacity, which may be acquired or inherited, or both, was first noted by Bowlby (1944) in his study of delinquent adolescents, some of whom he labeled “affectionless.” Instead of seeking proximity to others as a way to feel affection and closeness, and to ward off loneliness, the psychopath appears most concerned with dominating his objects to control them. This domination reduces threats to him and stimulates his grandiosity, but also diminishes the probability of any empathy and inhibition of aggressive impulse. It is phylogenetically a prey-predator dynamic (Meloy, 1988), often viscerally or tactilely felt by the psychiatrist as an acute autonomic fear response in the presence of the patient without an overt behavioral threat: the hair standing up on the neck, so-called goose bumps, or an inexplicable “creepy” or “uneasy” feeling. These are atavistic reactions that may signal real danger and should never be ignored; they necessitate a careful and thorough psychodiagnostic workup and treatment plan.
The third psychodynamic of the psychopath that is often a facet of his evil deeds is his deception of others. Psychopaths are chronic liars, and research indicates that we are most likely to be misled by the special skill we think we possess to detect lying (Ekman, 1985). The psychopath lies for many reasons, the most common to experience the feeling of contemptuous delight when he successfully carries out his deception (Bursten, 1972). This purpose sharply contrasts with normal lying, which is usually done to reduce the anxiety surrounding possible rejection by an angry object to whom one is bonded.
Without conscience, there is no guilt. And without guilt, the positive feeling aroused by deception both fuels the psychopath’s grandiosity—his belief, for example, that he is smarter than most—and acts as an intermittent positive reinforcement. He is therefore more likely to deceive again. The mendacity of the psychopath is enormous and is usually best uncovered through scrutiny of the known details of his behavior and history independently of his self-report. The best psychometric assessment of deception concerning psychiatric disorder, what we normally diagnose as malingering, is a combination of the validity scales of the MMPI-2 and the Structured Interview of Reported Symptoms, a relatively new clinical interview (Rogers, 1992).
These three aspects of the psychopath—behavioral devaluation of others, chronic emotional detachment, and mendacity—are the catalyzing agents of his wickedness. The historical path of his life is marked by the hurt, wounded, and angry people he leaves behind, sometimes unwittingly stripped of their own capacity for goodness.
THE SADIST
The term “sadism” was coined by Krafft-Ebing (1886) and is based on the life and writings of the Marquis de Sade, who, surprisingly, lived to the respectable age of 74 (Lever, 1993). Notwithstanding its multiple meanings and often confusing and speculative literature (Mollinger, 1982), I am using the term to describe people who derive pleasure from the control, domination, and suffering of others. I treat sexual sadism as a more channeled variant (Shapiro, 1981), characterized by sexual arousal stimulated by the psychological or physical suffering of another. The DSM-IV has simplified things for us by eliminating sadistic personality disorder, but burning the map does not eliminate the territory. As Michael Stone (personal communication, March, 1996) said, “Sadistic Personality Disorder: not in the DSM, but still in the USA.” The most comprehensive analysis of the sadistic personality has been done by Millon (1996).
The derivation of pleasure through the subjugation and control of others and their consequent pain is an impulse-affect that has received very little empirical attention and far more theoretical speculation. A review of the 1967–1992 extant research that I conducted (Meloy, 1992) yielded 70 citations, of which only one in four were empirical studies. There was a virtual absence of any measurable treatment studies: only three uncontrolled case studies, which focused on sexual sadism. One study used cyproterone acetate (Bradford and Pawlak, 1987); another used an olfactory aversion procedure (Laws, Meyer, and Holmen, 1978); and the third employed self-administered covert desensitization (Hayes, Brownell, and Barlow, 1978). All three showed positive treatment outcomes.
We clinically know characterological sadism, however, when we see it. The antisocial inpatient incessantly teases others and derives pleasure from their discomfort. The spouse batterer smiles broadly as he shamelessly recounts his assault on his wife. And most disturbing is the child who does not angrily kick his pet, but instead tortures animals with detached pleasure. We also know that the latter behavior, cruelty toward animals, correlates with adult violence (Felthous and Kellert, 1986), but the causative factors of sadism, whether biogenic or psychogenic, are unknown.
There is a growing body of empirical work on both consensual and criminal sexual sadism. The subculture of consensual heterosexual and homosexual sadomasochism has been explored through surveys. Spengler (1977) conducted the first study of male sadomasochists in Germany. In another study, sadomasochistic women appeared to be more extroverted, less neurotic, more psychopathic, and more sexually active than controls (Gosselin, Wilson, and Barrett, 1991). Self-defined sadomasochists are predominantly heterosexual, well educated, relatively affluent, and interested in both domination and submission; they engage in a wide range of sexual activities (Moser and Levitt, 1987). Breslow (1992) conducted the largest survey study to date in the United States and found that consensual sadomasochists included both men and women who were predominantly Caucasian, had a wide range of education, did not hide their proclivities from their significant other, had had an average of six partners during the past year, mostly engaged in oral sex and spanking, and were remarkably free of self-reported depressive and negative feelings about their sexual interests.
It appears that this abnormal expression of sexual behavior does not evoke wickedness or evil. I will instead focus on criminal sexual sadism, which by definition (DSM-IV) requires the paraphilia, a nonconsensual object, usually an abducted or captured victim, and psychological or physical torture. Here the paths of sadism and psychopathy cross and our species’ capacity for evil is most apparent.
Two studies have scrutinized the offender and offense characteristics of the criminal sexual sadist for the first time. Dietz, Hazelwood, and Warren (1990) conducted an exploratory, descriptive study of a small, nonrandom sample (N = 30) of criminal sexual sadists, the majority of whom had murdered three or more victims. Virtually all the subjects were Caucasian males; the majority had not experienced parental infidelity or divorce, physical abuse, or sexual abuse as children. The banality of their known histories was surpassed only by the extraordinary cruelty of their offenses. The majority of the subjects had carefully planned their offense, taken the bound, blindfolded, or gagged victims to a preselected location, kept the victim in captivity for at least a day, and proceeded to rape anally, force fellatio, beat, and vaginally rape them (in descending order of frequency) before murdering them and concealing the corpses. Most of the sexual sadists also recorded their offenses, presumably to memorialize their victims’ suffering and to use for masturbatory stimulation between offenses. There were sufficient data to conclude that virtually all the subjects remained unemotional and detached during their torturing and murdering.
Gratzer and Bradford (1995), mindful of the risks of uncontrolled research, conducted a comparative study of the Dietz sample, their own sample of criminal sexual sadists (N = 28) from the Royal Ottawa Hospital (ROH), and a sample of nonsadistic sexual murderers (N = 29). The sadistic murderers as a combined group had a significantly greater frequency of physical abuse, cross-dressing, voyeurism, exhibitionism, and homosexual experiences in their history than did the nonsadistic sexual murderers. They were also significantly more likely to plan their offense, preselect a location, and beat, anally rape, bind, and force fellatio on their victims. Emotional detachment and sexual dysfunction also distinguished them. Eighty-six per cent of the sexually sadistic murderers (ROH sample only) were antisocial personality disordered, and the majority had measurable neurological impairments.
Neither study (Dietz, Hazelwood, and Warren, 1990; Gratzer and Bradford, 1995) measured psychopathy, but the convergence with sexual sadism is strongly suggestive and expectable: both the psychopath and the sexual sadist share a desire and will to control and dominate their objects, a chronic emotional detachment that dehumanizes their objects, an aggressive narcissism that entitles them to do what they want to their objects, and a mendacity that both delights them and facilitates their abduction of their objects. We have recently found empirically that psychopathy and sadism are significantly and positively correlated, with a sufficient magnitude (effect size) to warrant further study (Holt, Meloy, and Strack, 1999).
CONCLUDING REMARKS
If we are to manage the wickedness of psychopathy and sadism clinically, we must first accept its reality. Regardless of the biogenic and psychogenic roots of these human disorders, we must look upon them with a scientific objectivity unfettered by a naive optimism that all psychopathology is treatable or, if not, will ameliorate in time. We must also be willing, at the same time, to exercise moral choice and judgment of those who act in such nefarious ways. For the most difficult decisions in life are moral. And the most difficult acts in life are those which demand moral courage.
If we lose sight of these complementary and distinct aspirations—to seek scientific objectivity and to also exercise moral choice and judgment—then we risk contaminating our scientific advancements with bias or abdicating moral responsibility in the service of scientific achievement. Without such aspirations, that “morning-star of evil,” in Wilde’s words, may begin to believe in us.
REFERENCES
American Psychiatric Association (1968). Diagnostic and Statistical Manual of Mental Disorders, 2nd ed. Washington, DC: American Psychiatric Association.
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: American Psychiatric Association.
Berke, J. H. (1988). The Tyranny of Malice. New York: Summit Books.
Bowlby, J. (1944). Forty-four juvenile thieves: Their characters and home-life. Internat. J. Psycho-Anal., 25:19–53, 107–128.
Bradford, J. & Pawlak, A. (1987). Sadistic homosexual pedophilia: Treatment with cyproterone acetate: A single case study. Canadian J. Psychiat., 32:22–30.
Breslow, N. (1992). Sadomasochism: A Report of a 10-Year Study into Sadomasochism Among Consenting Adults. Los Angeles: Oceanside Press.
Bursten, B. (1972). The manipulative personality. Arch. Gen. Psychiat., 26: 318–321.
Cleckley, H. (1941). The Mask of Sanity. St. Louis, MO: Mosby.
Dietz, P., Hazelwood, R. & Warren, J. (1990). The sexually sadistic criminal and his offenses. Bull. Amer. Acad Psychiat. & the Law, 18:163–178.
Ekman, P. (1985). Telling Lies. New York: Norton.
Felthous, A. & Kellert, S. (1986). Violence against animals and people: Is aggression against living creatures generalized? Bull. Amer. Acad. Psychiat. & the Law, 14:55–69.
Gacono, C. B. & Meloy, J. R. (1991). A Rorschach investigation of attachment and anxiety in antisocial personality disorder. J. Nerv. Ment. Dis., 179: 546–552.
Gosselin, C., Wilson, G. & Barrett, P. (1991). The personality and sexual preferences of sadomasochistic women. Personal. & Individ. Differences, 12:11–15.
Gratzer, T. & Bradford, J. (1995). Offender and offense characteristics of sexual sadists: A comparative study. J. Forensic Sci., 40:450–455.
Hare, R. D. (1991). The Hare Psychopathy Checklist, rev. manual. Toronto: Multihealth Systems.
Hare, R. D., Hart, S. D. & Harpur, T. J. (1991). Psychopathy and the proposed DSM-IV criteria for antisocial personality disorder. J. Abn. Psychol., 100: 391–398.
Harpur, T., Hakstian, A. R. & Hare, R. (1988). Factor structure of the psychopathy checklist. J. Consult. & Clin. Psychol., 56:741–747.
Hayes, S., Brownell, K. & Barlow, D. (1978). The use of self-administered covert sensitization in the treatment of exhibitionism and sadism. Behav. Ther., 9:283–289.
Holt, S., Meloy, J. R. & Strack, S. (1999). Sadism and psychopathy in violent and sexually violent offenders. J. Amer. Acad. Psychiat. Law, 27:23–32.
Klein, M. (1975). Envy and Gratitude and Other Works 1946–1963. New York: Free Press.
Krafft-Ebing, R. von. (1886). Psychopathia Sexualis: A Medico-Forensic Study. New York: Putnam, 1965.
Laws, D., Meyer, J. & Holmen, M. (1978). Reduction of sadistic sexual arousal by olfactory aversion: A case study. Behav. Res. & Ther., 16: 281–285.
Lever, M. (1993). Sade/A Biography. New York: Farrar, Straus & Giroux.
Lion, J. & Leaff, L. (1973). On the hazards of assessing character pathology in an outpatient setting. Psychiat. Quart., 47:104–109.
Meloy, J. R. (1988). The Psychopathic Mind: Origins, Dynamics and Treatment. Northvale, NJ: Aronson.
Meloy, J. R. (1992). Violent Attachments. Northvale, NJ: Aronson.
Meloy, J. R. (1995). Antisocial personality disorder. In: Treatments of Psychiatric Disorders, Vol. 2, ed. G. Gabbard. Washington, DC: American Psychiatric Press, pp. 2273–2290.
Millon, T. (1996). Disorders of Personality: DSM-IV and Beyond. New York: Wiley.
Mollinger, R. (1982). Sadomasochism and developmental stages. Psychoanal. Rev., 69:379–389.
Moser, C. & Levitt, E. (1987). An exploratory-descriptive study of a sadomasochistically oriented sample. J. Sex Res., 23:322–337.
Raine, A. (1993). The Psychopathology of Crime. San Diego: Academic Press.
Rice, M., Harris, G. & Cormier, C. (1992). An evaluation of a maximum security therapeutic community for psychopaths and other mentally disordered offenders. Law & Human Behav., 16:399–412.
Rogers, R. (1992). Structured Interview of Reported Symptoms. Odessa, FL: Psychological Assessment Resources.
Serin, R. (1991). Psychopathy and violence in criminals. J. Interpers. Viol., 6:423–431.
Shapiro, D. (1981). Autonomy and Rigid Character. New York: Basic Books.
Spengler, A. (1977). Manifest sadomasochism of males: Results of an empirical study. Arch. Sex. Behav., 6:441–456.