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This is one of an occasionally-appearing series on topics having to do with psychiatry and mental illness.  Ever since Freud first wrote about young women sickened by their repressed sexual thoughts, America has been fascinated by the world of psychiatry.  And given that salacious introduction to the world of mental disorders, who wouldn't be fascinated?  I too have been fascinated by the field of psychiatry, and I hope this series of articles will explain some of that fascination to readers in ways that are both enjoyable and enlightening.  For interested readers, the other installments of this series can be found here: http://www.dailykos.com/...
and here: http://www.dailykos.com/...

To a lot of Americans, it seems our country is being run by crazy people.  Examples are plentiful.  After the terrorist attacks on 9/11, we retaliated by invading a country that had nothing to do with the attacks, and in doing so ended up killing more young Americans than did the terrorists themselves.  After photographs of US military personnel torturing detainees were made public, our president repeatedly stood before TV cameras to intone “The United States does not torture”.  A congressman witnessed by police soliciting sex in a men's restroom insists on re-litigating his own guilty plea.  Some of our leaders seriously suggest removing the topic of evolution from school science textbooks, and supplant it with Biblical creation stories.  A governor goes on TV to report her state is being overrun by headless bodies.  Our congress refuses to address pressing financial matters.  Business leaders call for greater exploitation of petroleum resources, even as scientists tell us our use of petroleum products is making the planet uninhabitable.  One of our presidential candidates complains that large portions of the electorate don't pay taxes, even as he banks his wealth in tax-free havens overseas.      

So, whether we consider our political leaders, our business leaders, or our military leaders, there is plenty of objective evidence for thinking that the people who run our country have lost their minds.  And we are talking about some the the most accomplished people in the country; men and women educated at the finest universities in the land, running great commercial enterprises, elected to high office, and possessors of great wealth.  These are people who are invited regularly on TV to explain to the rest of us the workings of our country.  So how is it that the most accomplished, the wealthiest, and the highest holders of public office so often seem to be acting blatantly crazy?

I believe it is because many of them are literally crazy, or if not outright crazy, at least possessed of enough craziness to matter.  The craziness afflicting our leaders is I think, something the psychologists call psychopathy (sy-cop-a-thee).  Psychopathy has been characterized as a condition of shallow emotions, selfishness and irresponsibility, manipulativeness, and an overall disregard for the well-being and feelings of others.  Psychopathy is not recognized as an actual illness or disease by psychiatrists.  The field of psychiatry recognizes something similar called Antisocial Personality Disorder, which shares features of Psychopathy.  But to the psychiatrists, a personality disorder is not an illness per se, but rather “an enduring pattern of inner experience and behavior....is pervasive and inflexible...is stable over time, and leads to distress or impairment” (APA.  Diagnostic and Statistical Manual IV-TR.  2000).  In other words, Antisocial and other Personality Disorders are not illnesses because they do not represent a deviation from an individual's “normal” state, but rather characterize the individual's default thinking and behaviors.  And perhaps more importantly, psychiatrists have no cure or treatment for personality disorders.  Rather, psychiatrists recommend counseling, not as treatment, but to educate the sufferer to avoid and modify the more damaging behaviors of their condition.

So psychopathy exists as a sort of orphan; widely recognized but not an actual illness.  While no psychiatric or psychological organization recognizes an actual illness called psychopathy, assessments of psychopathy are done routinely, especially in the criminal justice system.  The term psychopathy and its measurement  has been widely promoted by psychologist Robert Hare, the designer of the Hare Psychopathy Checklist (now called the Psychopathy Checklist-Revised, or PCL-R for short).  The PCL-R is the most commonly used assessment tool for the study of psychopathy, and is widely considered the “gold standard” by which psychopathy is judged.  Dr. Hare developed the PCL-R for studying criminals, and most of his initial research on psychopathy was done in prisons.  The PCL-R lists 20 essential features or characteristics of psychopathy, and assigns a score based on how well the 20 features match the individual being assessed.  A label of “psychopathy” is given to anyone whose score rises above a given threshold.  Every year, Dr. Hare runs a workshop to educate and train doctors, nurses, social workers and interested others in the use of the PCL-R, and if you are interested, you too could be trained by Dr. Hare himself in the identification of psychopathy (assuming you can pay the fee).

Here is the list of the features and characteristics of psychopathy, as outlined by the PCL-R.

* Glibness/Superficial Charm
*
Grandiose Sense of Self-Worth
* Need for Stimulation/Frequently Bored – the subject is easily bored, and craves excitement
*
Pathological Lying – An individual for whom lying is a characteristic feature of interactions with others
* Cunning/Manipulative – The individual is adept at manipulating others
*
Lack of Remorse or Guilt – The individual seems unable to express remorse or guilt
* Shallow Affect – The individual seems to have a poverty of affect, and is unable to experience a normal range and depth of emotion.
*
Callous/Lack of Empathy – A disregard for the feelings or condition of others
* Parasitic Lifestyle – Relationships with others are commonly parasitic in nature
*
Poor Behavioral Controls – Behavior is commonly risky and impulsive
* Promiscuous Sexual Behavior – Frequent, multiple sexual encounters
*
Early Behavioral Problems – A history of antisocial behaviors beginning in childhood or adolescence.
* Lack of Realistic Long-Term Goals
*
Impulsivity
* Failure to Honor Obligations and Commitments
*
Failure to Accept Responsibility for Own Actions
* Many Short-Term Marital Relationships – A history of multiple marriages of short duration.
*
Juvenile Delinquency – A history of criminal activity beginning in childhood or adolescence
* Revocation of Conditional Release – The individual is unable to adhere to the conditions of parole or probation
*
Versatility of Criminality – The individual has a wide repertoire of criminal behaviors
Most psychologists recognize that psychopathy exists as a continuum, and how the various features present in different individuals can range from subtle to overt.  Some researchers have suggested there exists sub-types of psychopaths – including Primary Psychopaths (the hard-core criminals), Distempered Psychopaths (people who seem to crave the “rush” and excitement of their bad behaviors), and Charismatic Psychopaths (charming and attractive liars and con-men).

Unlike schizophrenics or depressed people, the typical psychopath outwardly appear quite normal and usually quite likeable.  They are typically agreeable and friendly in social settings, and appear to have good sense and sound reasoning.  The common saying among psychiatrists and psychologists is that good evidence for a diagnosis of psychopathy can be found in the doctor's own positive response to a new acquaintance who seeks to borrow money or cash checks.  It is only after a period of time with a psychopath that you discover repeated lying and a remarkably consistent failure to honor past promises.  The psychopath's unreliability and disregard for consequences appears in matters great and small, and always masked by displays of confidence and conforming and acceptable behaviors.  A psychopath will commit acts of theft, forgery, adultery, fraud, and lies without any apparent compunction, and often for the smallest possible stakes, and sometimes in the absence of any goal whatsoever.  Psychopaths appear to have zero understanding of others' emotional responses: they seem to be entirely baffled by another person's hurt or happiness, anger or upset.  Many experts remark that psychopaths take a keen interest in the emotional displays of other people, in an apparent effort to better mimic those emotions for the purpose of being more effective manipulators.  Psychopaths themselves have a kind of emotional poverty.  A psychopath's own emotions often appear perfunctory; more like play-acting than a display of depth of feeling.  If you point any of these traits or behaviors out to the psychopath, they typically respond with hurt surprise and vexation: they are such a wonderful person the misunderstanding must be yours.  The psychopath cannot accept blame for misfortunes; if they have been brought down, it is only because of the faults of others.

Now here's the fun part: take your favorite national leader – Mitt Romney, say – and let's see how closely the descriptions match the man.  Glib?  You betcha.  Grandiose sense of self-worth?  He is convinced he should be leader of the free world, after all.  Pathological lying?  Every time his lips move.  Shallow affect?  That would account for all the jokes about being an alien.  Callous?  His platform is build on the notion of no more free rides for the servant classes.  Lack of Remorse?  This is a man whose autobiography is titled “No Apologies”.  A lack of realistic goals?  Of course he can cut taxes, spend more on the military, and balance the budget, just like Reagan   And so on.  Granted, there are many features of the PCL-R that do not match up with Gov. Romney: promiscuous sexual behaviors, many short marriages, loss of parole, and others.  The absence of some behaviors does not rule out the diagnosis; the diagnosis is made on the sum total of all behaviors.  So I'm willing to bet that if Gov. Romney were to sit down to a two-hour interview with a trained examiner, Gov. Romney would score pretty high on the PCL-R.  If you were to look up the heading “Charismatic Psychopath” in the dictionary, you just might well find Mitt Romney's picture there.

Pres. GW Bush might also score very high.  And perhaps John Edwards.  Or even Bill Clinton.  What about Joe Kennedy, or his son Jack? Or the Carnegies, the Rockefellers, and the Vanderbilts? Gen. George S. Patton, or Ulysses S. Grant?  The history of America is replete with stories of ambitious driven men, who were willing to let nothing stand in their way to become president, or build a commercial empire, or win a battle.  Men whose over-sized egos convinced them they could do no wrong, and who were willing to lie, cheat, and steal their way to the top.

I am convinced that our national leaders, in politics, in business, in the military, and in many other spheres, so often act like they are crazy because many of them indeed have a sort of craziness called psychopathy.  Moreover, I am convinced that the traits of psychopathy confer an advantage to those who seek to climb to the top; and that the effort to become a national leader selects for people who are better psychopaths. In other words, a sort of societal evolution favors those leaders who possess the necessary features of psychopathy.  Face it: it you want to get to the pinnacle of politics or business, an over-grown sense of your own importance is necessary; being able to charm and manipulate others is going to be very important; and you can't let little things like the truth or the well-being of others get in your way.  A psychopath endowed with intelligence and ambition, and the right mix of psychopathic traits, can be richly rewarded in our society.  While the everyday run-of the-mill psychopath imagines taking the rent money from from whomever he has convinced to fall in love with him, the corporate psychopath conceives of a way to steal millions from the masses by rigging petroleum futures or maybe election results.  And the higher up you go, the more important the features and traits of psychopathy are going to be for continued success: the Mitt Romney's of the world have been trained over decades in the arts of successfully lying and manipulations.  I think this explains the preponderance of damaging sexual liaisons by our leaders, the constant lying and mis-representations of obvious facts, and the frequent failure to acknowledge the consequences of their actions (“the CIA gave us bad intelligence”, not “I lied to you”).

Thankfully, not all our leader behave in this way.  There exist men and women in leadership positions around the country who are honest, caring, and devoted to promoting a greater good.  Just as obviously,  there exist too many men and women of prominence who are dedicated first and foremost to themselves, and who are predators perfectly happy to step on anyone and everyone to gain fame and fortune.  And because these are the movers and shakers of our society, their thinking and actions have consequences for us all.  Mitt Romney may yet lose this election, but he will remain an influential voice in conservative politics and in the world of business for years to come: the effort to move jobs overseas and cut taxes for the wealthy will not end with a Romney loss.  There are other clever manipulators out there watching and taking notes.

So you can be forgiven for imagining that some of our national leaders in politics, business, and the military are just plain nuts.  A lot of them are indeed crazy.  Just not in ways that can be treated by any doctor.

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