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Without Conscience

The disturbing world of the psychopaths among us
Robert D Hare, PhD.
Published by the Guildford Press. ISBN 1-57230- 451-0

I have attempted to summarise the content of a 220 page book in under 500 words. I hope the following gives you an idea of what we are up against. This is an awesome book, solidly researched, by a Canadian professor of psychology with a background in experimental psychology and cognitive psychophysiology, yet it's a damn good read, not excessively technical, abstract or difficult to follow.

Based on 25 years of scientific research, this book clearly describes in layman's terms the problem of psychopaths- people who are not mad, at least not by current legal and psychiatric standards. Instead, they have a cold, calculating rationality, combined with an inability to treat anyone else as a thinking feeling human being. They are self-centred, callous and remorseless, profoundly lacking in empathy and who function without the restraints of conscience.

Dr Hare and his research team, working at the University of British Columbia, established a diagnostic tool, the psychopathic checklist, which is now used by clinicians, researchers and forensic psychologists and psychiatrists around the world. Standard psychological tests are of little use as they largely rely on self-reporting by the subjects, and the inmate populations he was working with are quite adept at figuring out the "right" answers for tests and interviews.

The prevalence of psychopathy in society is about the same as that of schizophrenia, about 1%, but the pain and damage caused is far more extensive. The causes are not currently known for certain, but evidence points more to nature than nurture. EEG charts show electrical activity in the brains of psychopaths to be markedly different to that of normal people.

The symptoms are usually evident from childhood, including casual constant lying, hurting/killing animals, persistent aggression and indifference to the pain of others. They come from the best and worst of families and everything in between. Often their siblings are completely normal, indicating that upbringing and background has little or nothing to do with it, so parents are not to blame.

The shortest chapter is that on treatment. Nothing works. No effective treatment has yet been found. Conventional therapy may actually make them worse if anything. This is because psychopaths feel they don't have psychological or emotional problems. They are not "fragile" individuals, quite the opposite. All they do in therapy is go through the motions and collect new excuses and rationalisations for their behaviour and fresh insights into the vulnerabilities of others.

Not all psychopaths are violent, many operate in more subtle ways, e.g. white collar crime, or subcriminal behaviour, which although not technically illegal, is unethical and morally dubious.

Over 50% of those imprisoned for serious violent offences are psychopathic, and the recidivism rate for such offenders is triple that of other offenders. Here is an apt quote from the book: "If crime is the job description, the psychopath is the perfect applicant". The problem is worsened by their ability to lie convincingly and with ease to parole boards who are all too inclined to believe them. Then they promptly reoffend....doesn't that just sound familiar!

Robert P. Hare PhD, considered one of the world's foremost experts in the area of pschopathy, is a professor of psychology at the University of British Columbia. There he developed the Psychopathy checklist, which is rapidly being adopted worldwide as the standard instrument for researchers and clinicians. Dr Hare has written two previous books, and numerous articles, on psychopathy. See his website here.