We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
Here are the problems, with which I am sure most people in my field would agree. First, most serious psychopaths rarely seek help, and then usually only when they get in trouble. Second, lying and manipulating are second nature to them, so they try to play you. Some are quite adept. Third, they tend to be unreliable with showing up or paying their bills.
There are others, too.
In my experience, when people come to me worrying about whether they have a cold or dark heart, or feeling guilty about some pattern of behavior, it's a good sign that they are far from psychopathic.
I will offer the opinion that there are full-blown psychopaths, very scary people. However, there are people with a range of psychopathic (ie sociopathic) traits which are worth being alert to. On the other end of the spectrum, most people have psychopathic fantasies which they never, or very rarely, act on.
No mortal is pure of heart. It's complicated. It's not a disease.
I think it's a grave category error to confuse sin with 'mental illness'. In the beginning of the clerical child sexual abuse scandals within the Catholic Church, those charged with dealing with the perpetrators deferred to the sex counsellors who claimed they could 'cure' these abusers. The consequences disastrously propagated the problem. The bishops should have treated the abusers as the most depraved of sinners and should have handed them over to the 'secular arm', in other words, the police.
A psychopath is a person who chooses evil ways as the norm in going about his business and daily life. There is no blood, hepatic or urine test that can ever define him.
Psychopathy is not curable, but like any other affliction, it is treatable. That is not to say that any or all treatments produce the desired result. Perhaps the best treatment currently available for psychopathy is long-term institutionalization. This may not make the patient any better, but like quarantines of old, the goal isn't always to cure the patient, but to prevent the patient from damaging others.
Could it be that one man's psychopath is another man's brilliant tactician?
The diagnosis may be an external attempt to gauge a person's inner drives and methods, which, by virtue of being measured from the outside, cannot really grasp all the real and abstract motivations behind the subject's behavior.
If this is the case, then it is left to the observer to rate the subject on her deleterious effects on society - which is just another subjective attempt to grasp at abstracts, or on the subject's attempts to deceive or obfuscate the motivations behind her actions, which can be perceived, again, as professional bias fishing for medical confirmation.
When it comes to most of the field of psychology, especially that which falls outside of the testable, Biological studies, you call me a confirmed skeptic!
It would be interesting to learn more about the sociopathic scale, which I think exists. Just as there are people with autistic tendencies who are perfectly functional, there are those with sociopathic tendencies who are not dangerous at all. I can think of several occupations that require an ability to not feel empathy, at least not all the time. They aren't cold hearted people. They just make cold hearted decisions and don't get twisted up about it. There are others who might rank high on sociopathy, but control themselves through some system of ethics. It would be useful to know how and why.
I think acknowledging that there is a range is helpful. It also helps to remember that most problem behaviors in human beings are functional behaviors that have gotten out of control, not necessarily evil to the root. As Jack Walter notes, a lack of empathy is sometimes necessary for both the individual and the tribe. The line between manipulation and persuasion is going to be difficult to draw.
CS Lewis wrote in few places about vices and sins being virtues that are exaggerated, or unmoored from other virtues so that they control the personality. Evil is not self-existent, it is only spoiled goodness.
Assistant Village Idiot
Probably there's a connection between our inner voice, our boundaries of conscience, and our feelings of guilt. When confronted with a moral dilemma, we have to choose between the pleasure we would feel now from doing the wrong thing, and the the guilt that we would feel later. Psychopaths completely discount feelings of guilt, because the memory of doing the wrong thing remains pleasurable. Narcissism probably also plays a role, because cruelty is actually an expression of superiority. So why feel guilty when hurting an inferior? Our inner voice is supposed to moderate evil by chastising immoral conduct, but if harming inferiors is not a moral crime to a person who believes that he is in a different category, then the inner voice won't have anything to say. The boundaries of conscience have not been violated, because there's nothing wrong with hurting sub-humans. Psychotic behavior, in itself, becomes a source of narcissistic supply. So the real question in treatment is whether or not a person can be taught to be earnest. The logic flow of a psychopath depends on cynicism, it's the idea that lesser people are also worse people; so they deserve whatever they get. But earnest people must really listen to their inner voice, because they feel that their actions should be a genuine expression of who they are. And of course, no one wants to feel guilty, so the act of being earnest is also an attempt to avoid actions which would cause unpleasant feelings. The boundaries of conscience become clear, because of the self-examining nature of trying to be true to oneself. Earnestness, sincerity, and naturalness are all connected. Children are very earnest, because there's no assumed persona to hold them back. So if you can promote earnestness in childhood, to sincerity in teenage years, then hopefully you'll get adults who are naturally nice people. Of course, for this to work, children and teenagers must be allowed to decide for themselves what to believe. They can't be told what to believe.