Well looking at the PCL-R, there are two clear factors here. Factor 1 (aggressive narcissism) and Factor 2 (Impulsivity). ASPD correlates well to factor 2 but not to factor 1. On the other hand, the world is full of douchebags who score quite highly on Factor 1. And these are the guys that make me **** my pants. In anger.
The blending of these two factors pisses me off. It is not logical. More importantly it obscures from sight a significant and far-reaching societal problem. It's the impulsivity of the ASPDer that gets them caught. It's that impulsivity that prevents them from doing more than ever hurting individuals they see face to face. Do not get me wrong. These are not good people, and they themselves do tremendous damage. But the very impulsivity that we have made a cornerstone of their diagnosis is what limits them. They slip up. They make mistakes. They get caught up in the moment. They get sloppy. And, for the most part, they never 'think big'.
But if the ability to manipulate others without conscience--for one's own ends or simply for pleasure--is truly what makes psychopathy such an evil phenomenon, shouldn't those with self-control and the ability to plan, protect themselves, and build an empire of pain be worthy of far more attention? These are the people who rule small or large empires. Those who seek out positions of power, in politics, in institutions, in business. Where their decisions affect many and who may act with an impunity lent to those whose crimes are nebulous. Those who deny a promotion because someone is prettier than they are, or wouldn't sleep with them. Who fire others or make their lives hell, simply because they are better. Who foment plots to thrust aside those who stand in their way, regardless of the damage whispered campaigns and hushed rumors confer upon their victims. Those who destroy others' lives, careers, and joys with no more than a second thought. Without committing a formal crime. Without suffering the sanction of society. These people are found in positions of power, and whereas the stereotypical sociopath may rape, kill, maim, or terrorize 5 or 10 people, they may destroy as many peoples' lives in smaller ways, with a single brush of a pen, a single stroke of a key, a single memo or decision. A sociopath of this kind and their petty manipulative ways takes a toll of hundreds, thousands, or even millions in their career.
What of the savvy sociopath? The person who wraps the mores and legal strictures of society around them like armor, wielding it as a weapon itself? What of those who so carefully plans and structures their behaviors that they hurt a thousand people and yet do no more than give us all a mocking smile and a one-fingered salute as the allegations and accusations fall away like a misting rain upon oilskin, laughing all the way as they bleed society to death by a thousand cuts? Surely these should be the ones we seek, wolves in sheeps clothing that they are.
First off, I absolutely love this post--and I don't say this often. Not only do I agree with the points you made so shrewdly, I am charmed by the beautiful poetic language. Secondly, your post makes me think you speak from the heart, almost as if this goes beyond your professional activities and patient contact. You may not be, and in that case you could make a good politician.
I usually associate psychopathy/ASPD with business, politics, but also entertainment (which is a business I guess), and law. Narcissism abounds in prestigious professions such as law and medicine.
The department head and the medical director of the clinic where I was working during my first year of psych grad training, had more than his fare share of narcissistic traits. In fact, he embodied Factor 1. He was tremendously successful. His name was on every research paper that came out of the clinic, not because he contributed significantly but simply because this is how things "worked" there. Should you be lucky enough to get a position, you shut your trap and let him take credit. And we took the blame when things went wrong. Watching him deal with patients, putting on his charming and caring persona--oh and his broken promises--just pushed me over the edge and I quit.
Of course this is nothing compared to compared to those in real positions of power who treat people like chess pieces for their own amusement, status and financial gain. I used to watch "Cops" thinking to myself,
you poor bastard, you were not smart enough to fudge the numbers and make millions from your business, or start wars and watch people die while you profit; instead you got caught and publicly humiliated for a bit of marijuana. Not to say that this person did not commit a crime but that the injustice of it all overwhelms me, specially when people who commit most atrocious crimes are often respected and celebrated for their "success" and "resolve."
I fully agree with you that the impulsive ones are the ones who get caught. It's a matter of intelligence and executive functioning. This is where narcissism and psychopathy overlap. Whether a president or a manager in charge of a couple of people, this person is narcissistic enough to only care about himself but aggressive enough that the only time he thinks of others is how to manipulate and abuse them for his own gain.
I do believe that we all have value and this includes the psychopath behind the scenes responsible for killing, torturing, and abusing millions, stealing poor people's hard-earned money, etc. Whether it's primary psychopathy (and more biological in nature) or secondary psychopathy or sociopathy (reaction to environmental factors and upbringing), this person is simply not able to fully understand the hurt he is causing or perhaps feels that he has no other options and that he has to survive in a dog-eat-dog world where exploitation is the norm.
However, given that I believe in human rights and justice, and take the philosophical position that we're all entitled to certain rights, I would love nothing more than to be able to identify these people, limit their power and influence (backed by law, the kind that is enforced swiftly), and have them meet their needs in other ways. This is of course nothing more than a fantasy as too many positions of authority in our world are already filled by aggressively narcissistic people--who are made for these harsh, unstable, and highly competitive environments.
