Q&A on Dangerous Personality Disorders Part 1

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I recently had the honour of appearing as a guest on Doug Bennett’s radio show ‘Unspun: An Experiment in Truth Telling’ on KKRN in Northern California. During our conversation, Doug Bennett and I explored dangerous personality disorders, what they are and how they are caused, and the damage that people with these disorders cause in the world. This blog has extracts from part 1 of the interview. The interview can be heard in full here.     

What are dangerous personality disorders?

Doug Bennett:  It is a great pleasure to have you on. Your book is not only fascinating to read, I want to thank you for providing that manuscript. One of the things that tickled me, I’ll start with the things that tickle me, but you have a quote in there from Hafiz, who is one of my favourite poets. And it goes like this: ‘The great religions are the ships, poets the lifeboats. Every sane person I know has jumped overboard.’ That just tickled me and it kind of brought into perspective some of the things that we are going to be talking about. Let’s go to some basics so our listeners have a place to maybe start in this discussion. Your research in the book focused on the role of certain psychological disorders in the leadership of our nations and how that has affected us both historically and also currently. I would appreciate it if you would give our listeners a brief explanation of the specific disorders that you’ve been studying and writing about and the ways that they shape our society.

Ian Hughes:  Ok, I guess one way to get started, my background as you know Doug is in science and one of the passions I guess for writing the book is that I think that science has now discovered something that is one of the most important things we’ve ever discovered. Freud famously said that three great advances have happened that really changed our perspective on the world. And he talked about the first one being Nicholas Copernicus and how Copernicus discovered that the Earth wasn’t the center of the Universe. The second one was Darwin and of course the discovery of evolution, and that we are not a specially created species, but are really part of nature. And then Freud, characteristically, described his own discovery of the unconscious as being the third great discovery that completely changed our perspective of the world. So I think what I’m writing about in the book is the discovery by psychologists and psychiatrists recently, of this small proportion of people in our society, in every society, that has this small number of personality disorders. And these personality disorders, there are three of them that I write about in the book. The first one is Psychopathy, the second one is Paranoid Personality Disorder, and the third is Narcissistic Personality Disorder.

So, personality disorders, what are they? There are around about twelve personality disorders that psychologists and psychiatrists have identified and most of these really are of no danger to other people. Most personality disorders, for example if you take Obsessive Compulsive Disorder, or Depressive Personality Disorder, those are personality disorders that cause more harm and upset to the person who has the disorder than they do to the people around them. The three personality disorders that I am focusing on are ones which I call dangerous personality disorders because the behavior and the mindset of the people who have these disorders really represents a threat to the people around them and to society in general.

So when I talk about this being a monumental discovery in science, I’m talking of the discovery that a small proportion of people, who suffer from these pathologically abnormal personalities, dominate the normal majority.  And the differences between that minority and the rest of us are sufficient that you could classify this minority almost as a different type of human being.  And again if we go back to Freud, in ‘Civilization and its Discontents’ Freud talked about the definition of civilization. In Freud’s words, civilization exists to try and contain violence, and the propensity of humanity for violence. But this new realization I think is that there is a minority in every society for whom civilization is impossible. Their personalities are such that they are not capable of living in a civilized manner with the rest of humanity.

What causes these disorders?

Doug:  And this small minority, it’s a very small minority, are they fairly common in everyday life. Are we going to meet these personalities in our everyday life? Are they a very small minority or are they pretty large?

Ian Hughes:     At the moment, the best estimate for psychopathy is about 1% of the population.  Robert Hare is one of the main psychiatrists who talks about this, and he says that psychopaths are responsible for over half of violent crime. So although they are a small minority, they have a massive impact in crime statistics, a massive impact on the level of violence within society. Narcissists represent an estimate of about 2%, and Paranoid Personality Disorder about 4%, that’s about the best estimates at the moment.

Maybe if I can describe a little bit more about the characteristics of these personality disorders because the title of my book is “Imperfect Design.”  The title is chosen deliberately. It’s not just the characteristics of the minority with these three personalities that’s important. It’s also the characteristics of everyone else’s psychology. And how the rest of us have certain characteristics if you like. We look to these people with respect, often put power in their hands, and often help them in terms of the evils that they perpetrate. So, maybe if I just spend a very short time just describing each of the three of them in more detail?

Doug:  Certainly, I think that would be helpful.

Ian Hughes:  For Psychopaths the main characteristic is a lack of empathy. So for psychopaths, the way I’ve described them in the book is that as infants, one of the characteristics of an infant is that they respond to their mother or to those around them in emotional dialogue, in an emotional conversation. They will respond to their mother’s happiness with smiles of their own. They respond to fear with fear of their own. So this is emotional communication -and particularly so in terms of empathy. That empathy is missing in psychopaths. At a certain stage in our development as infants, we learn that the difference between people and things in that people respond to us in emotional ways. People respond to us very differently than a chair would respond to us for example. But for Psychopaths, that difference never develops. Psychopaths look at people the same way as they look at things, and I write about in the book how that has horrific consequences in terms of the ability of psychopaths to deal with people, or to kill, with absolute lack of conscience, lack of empathy.

Narcissists have a different personality disorder which is one in which their mind is shaped to only allow them to believe that they are important. So, narcissists are unable and psychologically incapable of perceiving of the idea of equality, and I think that has huge implications. For most of history, we’ve lived in unequal societies, societies where there were Kings and Queens and Emperors and so forth. The development of more equal societies has been very bad news for narcissists because they came to live in societies where it is demanded of them that they act as equals and give rights to others on the same basis as themselves–. But for a narcissist their minds are frozen with this perspective that they are more important than anyone, that they are entitled to more wealth and power than anyone else. So as I said, the concept of equality is completely alien to them.

And finally, with Paranoid Personality Disorder, people with that disorder also you can think of in terms of a frozen state of mind. And again, if we go back to early child development, psychologists say that there are two states of mind that we have as very small children. One of those states of mind is a paranoid state of mind where the world is a very dangerous place and they are very frightened of everything around them.  The second state of mind which we gradually learn to move into, is one in which while the world may still be frightening, but we are able to contain that fear and we are able to start to think about things around us and not just react in terms of threat and violence. But again, for people with Paranoid Personality Disorder, their minds are frozen in this hyper-sensitive or hyper-alert state in which they see others as a threat, and are incapable of seeing those around them as anything other than a threat.

Doug:  Let me take a second here to remind our listeners, you are listening to “Unspun, An Experiment in Truth-Telling,” I’m your host Doug Bennett. With us today on the phone in Dublin, Ireland is Ian Hughes, nuclear physicist, psychologist and author and we’re discussing the roles of abnormal personalities in our world and what we can do to return to a saner world. We invite your questions and comments. Call in at 337- 1885. That’s our studio number. You might think about making a pledge at the same time and we’ll actually triple your pledge with matching donors this morning. So, make that call, 337-1885.

You talk about these specific personality disorders. Do they happen—actually this is kind of a two-part question First of all I am interested on whether this is genetically related or is this something that happens because they are not nurtured in childhood? Do we have any idea on the factors that actually create these personalities? And the second part of that question is, do these disorders occur simultaneously in the same people?

Ian Hughes:  Those are good questions and I think the second one is very important, as I’ll explain maybe when we talk about Stalin and Mao and Hitler – they had multiple personality disorders. In terms of the first question, there’s a lot of uncertainty as to the causes and a lot of controversy even around the delineation and definition of what these personality disorders are. The only thing that can be said for certain is that the causes of these personality disorders are partly genetic and partly nurture. As with anything in terms of genetics, geneticists would stress that genetics isn’t destiny. Even though people may have genes for certain diseases or disorders, that doesn’t necessarily mean that they will develop the particular disease or particular disorder. It’s almost always a combination of the two. I think that’s as much as psychologists can say at the moment in terms of these disorders.

In terms of your second question, it’s absolutely the case that these disorders often co-exist within the one individual. For example if you take Stalin, both Stalin and Mao would have had, obviously, Psychopathic Personality Disorder. Their disdain for the citizens of their own countries, the murder of civilians that they carried out, what is documented about what they said and in terms of what they knew they were doing… it’s clear that they were psychopathic.

I think Stalin was more paranoid than Mao. For example the history of the Great Terror in Russia, Stalin, from the moment that he got power, had wave after wave of massacres that were designed to get rid of the next enemy. There’s an excessive paranoia on Stalin’s part. There was always a new enemy that had to be annihilated.  I think in Mao’s case, Mao was extremely narcissistic and narcissism was probably stronger in him than it would have been in Stalin. That narcissism came through in terms of his vision for Chinese society and the lengths to which he was willing to go in order to make his vision a reality. He famously said that half of China may have to die in order for his plans for China to come to fruition. That’s what’s most dangerous. As I’ve said these personality disorders are dangerous in their own right, but when they come together in one personality, then that’s particularly lethal.

Should we be careful about who we call a psychopath?

Doug Bennett:  As you point out, that’s an interesting part of your book, because so many of us haven’t taken a close look at that, that era when Stalin and Mao were ruling their countries so brutally. But I see in America and also in almost all of the other western nations, but America and the UK specifically, I see some of these same sort of traits. And it’s easy to look back in history and maybe point a finger at the obvious people that are destructive and that are sick people that were in charge of their countries but when we look at…I think we need to look at ourselves currently too. I was going to ask you your opinion. I know it would be difficult for you to give a true opinion but I see people like Dick Cheney and Tony Blair as maybe qualifying as psychopathic elite, or displaying some of these kind of characteristics, and their effect on our societies has been pretty damaging. I just wanted to maybe open up that part of the discussion and get your opinion.

Ian Hughes:  First thing I’d say really is… when you say in a sense that it’s easy to point at the monsters of history and look at things a little bit in the past.  As you know from what I’ve written, most of what I’ve written is more historical, up until the 60’s or so in terms of Stalin and Mao. I’ve deliberately avoided going further than that into contemporary issues, and there’s a reason in doing that, because there’s a danger. There’s a lot of documented evidence around Mao, Stalin and Hitler and so on, and the scale of the crimes both domestically and foreign in terms of Hitler and Mao are such that in building the case it’s almost irrefutable that these people had these disorders. I think once we come into more contemporary events where the documentation and the research is not yet there to that extent, there’s a danger I think depending on what side we’re on in saying that this person is a psychopath, because without the psychological diagnosis, we can’t be sure. There’s a danger that it degenerates into finger pointing with each side saying your hero is a psychopath or your leader is a psychopath and ours isn’t. So I deliberately have kept away from more contemporary events for that reason, because in the first instance I am trying to get this idea of the damage that these personality disorders have accepted if you like regardless of what people’s political beliefs are. The real divide there is in society, the real divide there is in humanity, is not one between particular political parties, and it’s not one between particular nationalities, or one between religions and so forth. The real division is across and within each of those categories, between those who have these psychological abnormalities and the rest of humanity.

The second thing I think we can say when it comes to historical events, that is sometimes more difficult when it comes to more contemporary events, is that my argument is that for most of history, people with these personality disorders have held power. For most of history, the level of economic development was such that most people lived in abject poverty. Most people lived in rural areas. People weren’t been able to organize in unions for example. For most of history we were living in situations that left us very vulnerable to domination by people with these personality disorders. Real change happened with the industrial revolution and the start of economic growth, the start of real economic growth in history. First in Britain, then in Europe, then in the United States, when the level of social and technological changes that began to happen enabled the psychological normal majority to begin to get educated, begin to work together, begin to form collective political parties and unions and so on… and then begin to oppose the power of this psychologically abnormal elite. This has happened to various extents around the world. The poorer nations are still in the fairly early stages of development, and are still vulnerable to domination by psychopaths. Whereas, as countries become more developed and have more resources, then they are able to put in place defences against these elites.

I’ve talked about in the book a number of different defences that we have put in place. For example the rule of law that applies to everyone regardless of their wealth or power; electoral democracy which allows us, if people do get into power who are psychological disordered, gives us the opportunity to replace them; the separation of church and state which takes away the excuse, the rallying cry, that evil is being done in the name of God; social democracy, which is the redistribution of wealth in order to maintain a certain minimum standard of living for everyone; human rights legislation, and so forth. I think in Britain and in the United States a lot of these protections are in place because they have been fought for. A lot of these things came out of violent struggle. For example human rights legislation and the United Nations Universal Declaration of Human Rights came out of the horror of the Second World War. Most of these defences came out of violent struggle, but they are in place in the United States and in Europe and in Britain.

The question which I think you rightly raise is one about whether they are being undermined. The Irish writer Colm Toibin has said that the Taliban is always coming at us in one way or another. British MP Tony Benn said that it’s up to every generation to reclaim and defend what has been won. So I think all those defenses have been put in place. But I agree with you that there are signs in the United States, Britain and so forth, that we are living in a dangerous time in terms of the backlash in how those defences are being undermined.

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3 thoughts on “Q&A on Dangerous Personality Disorders Part 1

  1. I would like to note that the following statement – But this new realization I think is that there is a minority in every society for whom civilization is impossible. Their personalities are such that they are not capable of living in a civilized manner with the rest of humanity. – is questionable.
    It might well apply to sociopaths. However, narcissists and paranoid individuals have been treated in intensive psychotherapy, and they have become “capable of living in a civilized manner.” To say otherwise is simply stigmatizing and inaccurate. There are many examples of narcissists being treated in long-term psychotherapy to the point where they are no longer diagnosable as BPD. The books of Heinz Kohut and James Masterson in particular give extensive case examples where the narcissist’s personality changed dramatically and they became much more empathic, human, and able to relate mutually to other people. As for paranoid individuals, they can be very difficult to treat. But to the degree that they have borderline or narcissistic traits, they are also treatable because they will form transferences to therapists. Lawrence Hedges writes a lot about how early trauma hurts these individuals and makes it so difficult for them to trust. I feel it’s better to understand than from that empathic perspective, than to say that they are not capable of living in a civilized manner (what is civilized, anyway?).

  2. I agree that narcissistic personality disorder and paranoid personality disorder may respond to intensive psychotherapy. Unfortunately, it is difficult to see how current methods of psychotherapy can deal with the scale of the problem that people with these disorders represent. Narcissists in particular are unlikely to present themselves for therapy because they see others as the problem, not themselves. And the time and costs associated with effective treatment are such that only a very small fraction of people with these disorders can have their condition treated.
    I agree that it is important to continue research for more effective treatments, as those you mention are doing. But I would stress the importance of deterrence through strengthening environmental factors – including the rule of law, the institutions of social democracy, and cultures which act as a check on psychopathic, narcissistic and paranoid behaviours.
    In answer to your question as to what civilised behaviour is, the best answer I can give is adherence to the principles set down in the Universal Declaration of Human Rights. Individuals and societies that can live by those principles meet the best definition of civilisation that humanity has yet devised.

  3. A book by investigative reporter Jane Mayer of the New Yorker mag in usa came out a few yrs. ago. It’s called The Dark Side. It presents a really clear picture of Dick Cheney’s particular personality disorder, though that was not the intent of the author. It’s quite remarkable, how clearly the personality disorder is observed and described by someone who is not coming at the subject from the psychiatric point of view at all, rather she was documenting the history of the secret interrogation practices. One of your 3 pathologies seems to be clearly dominant in the exVP, as I read the book. He’s not much of a mixed bag. Was wondering if you’re familiar with this book. It’s quite a good read for any student of abnormal psychology.

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