What is a psycho? 

Humantold October 21, 2022

If the word “psycho” conjures up images of serial killers and teen slasher films, you’re not alone. We don’t want to blame it all on the movies, but we have a misrepresentation problem and it’s shaped our cultural perception. So what does it really mean to be a psychopath?

What is a psychopath?

This may surprise you, but “psychopath” is not a true mental health diagnosis, nor does it only pertain to serial killers or violent criminals (though yes, Ted Bundy has been identified as a psychopath by most experts). Psychopathy is a personality trait and a spectrum. The term psychopath is used in clinical circles to describe a person who displays a set of traits. It usually overlaps with antisocial personality disorder (ASPD); 25-30 percent of people with ASPD also have psychopathy (compared to just one percent of the general population). 

Let’s confuse things even more for a minute here: the “antisocial” component of ASPD doesn’t refer to reclusiveness or loner tendencies, but rather behavior that conflicts with social norms. 

What’s that look like, exactly?

The traits of a psychopath

Lack of empathy is the hallmark trait of a psychopath, but a person’s psychopathic tendencies are gauged by a 20-item checklist, called the Hare Psychopathy Checklist-Revised (PCL-R). The checklist includes:

  • glib and superficial charm
  • grandiose (exaggeratedly high) estimation of self
  • need for stimulation
  • pathological lying
  • cunning and manipulativeness
  • lack of remorse or guilt
  • shallow affect (superficial emotional responsiveness)
  • callousness and lack of empathy
  • parasitic lifestyle
  • poor behavioral controls
  • sexual promiscuity
  • early behavior problems
  • lack of realistic long-term goals
  • impulsivity
  • irresponsibility
  • failure to accept responsibility for own actions
  • many short-term marital relationships
  • juvenile delinquency
  • revocation of conditional release
  • criminal versatility

Each item on the PCL-R receives a score of zero, one or two. A score of 30 or above classifies an individual as “psychopathic.” And men are more likely to exhibit psychopathic traits, with psychopathy found in about one percent of the male population compared to 0.3-0.7 percent of the female population.

OK, so are all psychopaths violent?

Contrary to what our favorite horror movies may tell us, not all psychopaths are violent. A higher PCL-R score does correspond to increased risk for aggression, crime and other “antisocial” behaviors, and it’s been estimated that half of all violent crimes in the US are committed by psychopaths. But remember that psychopathy is a spectrum and new research suggests some psychopathic people have greater impulse control than others, allowing them to “blend in” with society. 

Researchers differentiate between these two types of psychopaths as “unsuccessful” versus “successful,” the former behaving impulsively and lacking conscientiousness, while the latter can control impulses, suppress aggression and abstain from destructive and violent behavior. “Successful” psychopaths also have what’s referred to as a “resilience to chaos,” i.e. staying cool and collected under pressure, which might explain this now (somewhat infamous) statistic: CEOs are three times more likely to be psychopathic than the general population. 

Maybe the movies got something right with Gordon Gekko?

What causes psychopathy?

Sure, Hollywood loves to pin psychopathy on mother wounds (see “Scream” and “Psycho”), but science tells a more complex story. Like so many things, the exact cause isn’t known yet. But emerging research indicates the root of psychopathy is a combination of environmental and genetic factors, from faulty neural circuits making empathy difficult (or non-existent) in the psychopathic individual, to adverse parenting and exposure to toxins in utero. 

Is there treatment for psychopathy?

There is no known cure for psychopathy and there are conflicting opinions on whether or not successful treatment exists. It was long believed no medication or therapy could change psychopaths but newer research is more optimistic; an intervention called the “Decompression Model” reduced the likelihood that juvenile delinquents would reoffend by 34 percent and decreased violent crimes among those juveniles by 50 percent. The general idea: positive reinforcement. Developed and implemented by staff at the Mendota Juvenile Treatment Center in Wisconsin, the Decompression Model rewards incarcerated psychopathic individuals for good conduct, rather than punishing them for negative conduct. While it doesn’t appear to change intent among psychopaths, it may shape future behavior. 

Psychopath vs. sociopath – are they the same thing?

Again, more cultural confusion. The two terms are often used interchangeably but a sociopath is not the same as a psychopath. Both fall under the ASPD umbrella and have little understanding between right and wrong, but these are some key differences:

  • Psychopaths tend to be more manipulative, calculating and can sometimes maintain a normal facade, while sociopaths are more erratic, rage-prone and struggle to behave in socially acceptable ways. 

  • Psychopaths generally have less regard for others and disassociate easily, whereas a sociopath may experience guilt and remorse, albeit a limited amount.   

  • Psychopaths have a harder time forming attachments to others though they may mimic emotions to get what they want, while sociopaths may form close attachments to one or a few people.

  • Psychopaths do not rationalize their behavior while sociopaths may try to.

Some final food for thought: let’s stop calling people psycho 

To muddy the waters even more here, when we use the word “psycho” as an insult we’re again confusing “psychopathy,” but this time with another term: “psychosis.” Whereas psychopathy is a personality trait, psychosis is a mental state marked by one losing their grip on reality. Psychosis is usually a symptom of underlying mental illness, like severe depression, bipolar disorder, paranoid personality disorder, or schizophrenia. Using the term “psycho” derogatorily not only perpetuates the stigma of mental illness but may prevent people from seeking help when necessary. 

And by the way, Norman Bates would be classified as psychotic, not psychopathic.

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