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The Psychology of Wickedness: Psychopathy and Sadism by J PSYCHIATRIC ASPECTS OF WICKEDNESS The Psychology of Wickedness: Psychopathy and Sadism by J. REID MELOY, PhD 19th century German psychiatry. In that con­ text, such a patient would have been labeled a "constitutional psychopathic inferior": a phrase ecause I come from a long line of that itself interweaves both the Lombrosian Presbyterian ministers and have notion of a bad seed and the common moral judg­ • myself earned a graduate degree in ment that such people are less than human.3 A theology, I approach the question of century later, a substantial and growing body of mwickedness in psychology with an abundance of research argues that habitual criminality does, curiosity, but perhaps an insufficient humility. in fact, have a herit.able genetic loading.4 For wickedness, or evil, is outside the paradigm Following the classic and resurrective work of science, and, I think, should remain so. It is, of Cleckley,5 psychopathy has been carefully instead, the default of morality, or moral choice, and empirically defined by Hare6 as a constel­ and occupies the paradoxic position of being lation of traits and behaviors characterized by known to the science of psychology, yet not of it. two factors: (1) a callous and remorseless disre­ In the clinical practices of psychiatry and gard for the rights and feelings of others, and psychology, moreover, we cannot avoid occa· (2) a pattern of chronic antisocial behavior. This sionally coming face to face with patients who two·factor loading can be reliably assessed stimulate in us the thought that they are using the 20-item Psychopathy Checklist­ mean, wicked, or in some cases ra (Hebrew for Revised. 7 Such an assessment requires both a evil). Such patients live, in Oscar Wilde's clinical interview and scrutiny of independent words, "to give rebellion its fascination, and historical data, because of the mendacity of disobedience its charm," and they may truly such patients. At a certain quantitative thresh­ frighten us as clinicians. Fortunately, their old, the severe. psychopath can be clinically numbers appear to be few, because we have identified, and predictive validity studies indi­ now entered the diagnostic and psychodynam­ cate that the construct is not useless psycho­ ic landscape of the evil-doers, the wicked babble. Psychopaths are not amenable to treat­ ones-in psychology: psychopaths and sadists. ment,S and in one study were found to be more If we think about the psychology of wicked­ violent 10 years after immersion in a therapeu­ ness, these are the people we must study and tic community before release 9 They are also understand, yet fear. more dangerous than other criminals, and habitually engage in predatory, rather than THE PSYCHOPATH affective, violence. lO The former refers to The construct psychopathy was disavowed planned, purposeful, and emotionless violence, with the publication of the Diagnostic and usually toward strangers. The latter describes Statistical Manual, 2nd edition (DSM-Il),l but the reactive, emotional, and defensive violence has regained a tenuous foothold in DSM·rv.2 that could be described as the garden-variety Subsumed by the psychodiagnosis of antisocial hurtful aggression that mostly male members personality disorder, it is a much older and more of our species do, on occasion. Usually the vic­ clinically complex term that originated in late tims and perpetrators of affective violence are bonded to some degree. 1l In maximum security prisons, approximately three fourths of individ­ Dr, Meloy is Associate Clinical Professor of Psychiatry, uals will meet criteria for antisocial personality University of California, San Diego, and Chief, Court Services, Forensic Mental Health Division, San Diego County. disorder (according to DSM-IV), but only one Address reprint requests to J. Reid Meloy, PhD, 964 Fifth third of these individuals, at most, will be Ave" Ste.409, San Diego, CA 92101. psychopaths. 12 630 Psychiatric Annals 27:9/September 1997 Some of the psychodynamics of the psy­ The third psychodynamic of the psychopath chopath bring us closer to what we see as their that is often a facet of "wickedness" is his or her evil, or their wish to destroy goodness. Psycho­ deception of others. Psychopaths are chronic paths are aggressively narcissistic, and this liars, and research indicates that clinicians are aspect of their character pathology is often most likely to be misled by the special skill we expressed behaviorally by the repetitive deval­ think we possess to detect lying. 18 The psy­ uation of others, not predominantly in fantasy, chopath lies for many reasons, the most common as we see in narcissistic personality disorder of which is to experience the feeling of contemp­ but in reality. Psychopaths generally do this fo; tuous delight when a deception is successfully two reasons: first, to maintain grandiosity, or carried out. 19 This motive sharply contrasts with their sense of being larger than life, and second, normal lying, which is usually done to reduce to repair perceived insults or emotional wounds the anxiety surrounding possible rejection by an by retaliating against those they hold responsi­ angry person to whom one is bonded. ble. This repetitive devaluation of others, which Without conscience, there is no guilt. With· may range from verbal insults to serial homi­ out guilt, the positive feeling aroused by decep­ cide, also serves to diminish envy, an emotion 13 tion both fuels the psychopath's grandiosity­ highlighted by Klein and recently explored by the belief, for example, that he or she is smarter 14 Berke. Envy is the wish to possess the "good­ than most-and acts as an intermittent positive ness" perceived in others. If the "good object" reinforcement. The psychopath is therefore cannot be possessed, it must be destroyed or more likely to lie again. The mendacity of the damaged until it is not worth having. This idea psychopath can be enormous and is usually best of envy may, at first blush, seem quite theoreti­ uncovered through scrutiny ofthe known details cal, but is not if we imagine a very empathic of his or her behavior and history independent of and loving psychotherapist who extends his or his or her self-report. The best psychometric her caring-and perhaps violates his or her own assessment of deception concerning psychiatric professional boundaries-to help a psychopath­ disorder, what we normally diagnose as malin­ ic patient. The perceived goodness may, in fact, gering, is a combination of the validity scales stimulate the patient's envy and place the ther­ of the Minnesota Multiphasic Personality apist in great danger, both emotionally and Inventory (MMPI-2) and the Structured Inter­ physically. Psychotherapists particularly at risk view of Reported Symptoms, a relatively new are those who narcissistically invest (take great clinical interview.20 pride) in their capacity to heal others or love These three aspects of the psychopathic per­ others unconditionally and who may conse­ sonality-behavioral devaluation of others, quently engage in counterphobic denial of real chronic emotional detachment, and mendacity­ danger15 (eg, seeing the psychopathic patient in are the catalyzing agents of his or her wicked· his or her home office or at unusually late ness. The historical trail ofthe psychopath's life is hours, when no other staffare around, to accom­ often marked by the wounded and angry people modate the patient's schedule). he or she leaves behind, sometimes unwittingly Another psychodynamic that contributes to stripped of their own capacity for goodness. the psychopath's propensity to commit evil acts is chronic emotional detachment from others. 16 THE SADIST For the psychopath, relationships are defined by The term sadism was coined by Krafft­ power gradients, not affectional ties. This biolog­ Ebing21 and is based on the life and writings of ically based deficit in bonding capacity, which the Marquis de Sade, who surprisingly lived to may be acquired or inherited or both, was first the respectable age of 74.22 Because the term noted by Bowlby17 in his study of delinquent has multiple meanings and a confusing and adolescents, some of whom he labeled "affection­ speculative literature,23 I will clarify: I am using less." Instead of seeking proximity to others as a the term to describe individuals who derive way to feel affection and closeness and to ward ple"asure from the control, domination, and suf­ off loneliness, the psychopath appears most con­ fering of others. I will treat sexual sadism as a cerned with dominating his or her objects to con­ more channeled variant,24 characterized by sex­ trol them. This pattern reduces threats to the ual arousal stimulated by the psychologic or psychopath and stimulates his or her grandiosi­ physical suffering of another. The DSM-IV has ty, but also diminishes the probability of tried to simplify things by eliminating sadistic empathy and inhibition of aggressive impulse. It personality disorder, but burning the map does is phylogenetically a prey-predator dynamic,3 not eliminate the territory. As Michael Stone often viscerally or tactilely felt by the psychia. said, "sadistic personality disorder: not in the trist as an acute autonomic fear response in the DSM, but still in the USA" (personal communi­ presence of the patient without an overt behav­ cation, March 1996). The most comprehensive ioral threat: the hair standing up on the neck, analysis of the sadistic personality has been con­ goosebumps, or the more inexplicable "creepy" or ducted by Millon.25 "uneasy" feeling. These are atavistic reactions The derivation of pleasure through the sub­ that may signal real danger and should never jugation, control, and consequent pain of others be ignored; they necessitate a more careful and is an impulse-affect that has received very little thorough psychodiagnostic work-up and treat­ empiric attention and far more theoretical spec­ ment plan.
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