What are psychopathic tendencies

The Hidden Suffering of the Psychopath

The psychopath has the image of a cold, heartless, inhuman being. But do all psychopaths show a complete lack of normal emotional capacities and empathy?


Psychopathy is characterized by diagnostic features such as superficial charm, high intelligence, poor judgment and failure to learn from experience, pathological egocentricity and incapacity for love, lack of remorse or shame, impulsivity, grandiose sense of self-worth, pathological lying, manipulative behavior, poor self-control, promiscuous sexual behavior, juvenile delinquency, and criminal versatility, among others.1,2 As a consequence of these criteria, the image of the psychopath is that of a cold, heartless, inhuman being. But do all psychopaths show a complete lack of normal emotional capacities and empathy?

Like healthy people, many psychopaths love their parents, spouse, children, and pets in their own way, but they have difficulty in loving and trusting the rest of the world. Furthermore, psychopaths suffer emotionally as a consequence of separation, divorce, death of a beloved person, or dissatisfaction with their own deviant behavior.3

Sources of Sadness

Psychopaths can suffer emotional pain for a variety of reasons. As with anyone else, psychopaths have a deep wish to be loved and cared for. This desire remains frequently unfulfilled, however, because it is obviously not easy for another person to get close to someone with such repellent personality characteristics. Psychopaths are at least periodically aware of the effects of their behavior on others and can be genuinely saddened by their inability to control it. The lives of most psychopaths are devoid of a stable social network or warm, close bonds.

The life histories of psychopaths are often characterized by a chaotic family life, lack of parental attention and guidance, parental substance abuse and antisocial behavior, poor relationships, divorce, and adverse neighborhoods. 4 These persons may feel that they are prisoners of their own etiological determination and believe that they had, in comparison with normal people, fewer opportunities or advantages in life.

Despite their outward arrogance, psychopaths feel inferior to others and know they are stigmatized by their own behavior. Some psychopaths are superficially adapted to their environment and are even popular, but they feel they must carefully hide their true nature because it will not be acceptable to others. This leaves psychopaths with a difficult choice: adapt and participate in an empty, unreal life, or do not adapt and live a lonely life isolated from the social community. They see the love and friendship others share and feel dejected knowing they will never be part of it.

Psychopaths are known for needing excessive stimulation, but most foolhardy adventures only end in disillusionment because of conflicts with others and unrealistic expectations. Furthermore, many psychopaths are disheartened by their inability to control their sensation-seeking and are repeatedly confronted with their weaknesses. Although they may attempt to change, low fear response and associated inability to learn from experiences lead to repeated negative, frustrating, and depressing confrontations, including trouble with the justice system.

As psychopaths age, they are not able to continue their energy-consuming lifestyle and become burned-out and depressed while they look back on their restless life full of interpersonal discontentment. Their health deteriorates as the effects of their recklessness accumulate.

Emotional Pain and Violence

Social isolation, loneliness, and associated emotional pain in psychopaths may precede violent criminal acts.5 They believe that the whole world is against them and eventually become convinced that they deserve special privileges or rights to satisfy their desires. As psychopathic serial killers Jeffrey Dahmer and Dennis Nilsen expressed, violent psychopaths ultimately reach a point of no return, where they feel they have cut through the last thin connection with the normal world. Subsequently, their sadness and suffering increase, and their crimes become more and more bizarre.6

Dahmer and Nilsen have stated that they killed simply for company.5 Both men had no friends and their only social contacts were occasional encounters in homosexual bars. Nilsen watched television and talked for hours with the dead bodies of his victims; Dahmer consumed parts of his victims’ bodies in order to become one with them: he believed that in this way his victims lived further in his body.6

For the rest of us, it is unimaginable that these men were so lonely-yet they describe their loneliness and social failures as unbearably painful. Each created his own sadistic universe to avenge his experiences of rejection, abuse, humiliation, neglect, and emotional suffering.

Dahmer and Nilsen claimed that they did not enjoy the killing act itself. Dahmer tried to make zombies of his victims by injecting acid into their brains after he had numbed them with sleeping pills. He wanted complete control over his victims, but when that failed, he killed them. Nilsen felt much more comfortable with dead bodies than with living people-the dead could not leave him. He wrote poems and spoke tender words to the dead bodies, using them as long as possible for company. In other violent psychopaths, a relationship has been found between the intensity of sadness and loneliness and the degree of violence, recklessness, and impulsivity. 5,6


Violent psychopaths are at high risk for targeting their aggression toward themselves as much as toward others. A considerable number of psychopaths die a violent death a relatively short time after discharge from forensic psychiatric treatment as a result of their own behavior (for instance, as a consequence of risky driving or involvement in dangerous situations).7 Psychopaths may feel that all life is worthless, including their own.3,5,6


In the past decade, neurobiological explanations have become available for many of the traits of psychopathy. For example, impulsivity, recklessness/irresponsibility, hostility, and aggressiveness may be determined by abnormal levels of neurochemicals, including monoamine oxidase (MAO), serotonin and 5-hydroxyindoleacetic acid, triiodothyronine, free thyroxine, testosterone, cortisol, adrenocorticotropic hormone, and hormones of the hypothalamic-pituitary-adrenal and hypothalamic-pituitary-gonadal axes.8

Other features, such as sensation-seeking and an incapacity to learn from experiences, might be linked to cortical underarousal.4 Sensation-seeking could also be related to low levels of MAO and cortisol and high concentrations of gonadal hormones, as well as reduced prefrontal gray matter volume.9 Many psychopaths can thus be considered, at least to some degree, victims of neurobiologically determined behavioral abnormalities that, in turn, create a fixed gulf between them and the rest of the world.

It may be possible to diminish traits such as sensation-seeking, impulsivity, aggression, and related emotional pain with the help of psychotherapy, psychopharmacotherapy, and/or neurofeedback. Long-term psychotherapy (at least 5 years) seems effective in some categories of psychopaths, in so far as psychopathic personality traits may diminish.10-12

Psychotherapy alone may be insufficient to improve symptoms. Psychopharmacotherapy may help normalize neurobiological functions and related behavior/personality traits.13 Lithium is impressive in treating antisocial, aggressive, and assaultive behavior.14 Hollander15 found that mood stabilizers, such as divalproex, SSRIs, MAOIs, and neuroleptics, have documented efficacy in treating aggression and affective instability in impulsive patients. There have been no controlled studies of psychopharmacotherapy for other core features of psychopathy.

Cortical underarousal and low autonomic activity-reactivity can be substantially reduced with the help of adaptive neurofeedback techniques.16,17


Norman was raised by his aunt; his parents were divorced and neither was capable of or interested in caring for him. As a child and adolescent, he had numerous encounters with law enforcement for joyriding, theft, burglary, fraud, and assault and battery. He was sent to reform school twice. When he was 21, he was convicted of armed robbery and served 1½ years in jail. His only close friend was another violent criminal; he had many short-term relationships with girlfriends. At 29, he killed two strangers in a bar who had insulted him and was sentenced to forensic psychiatric treatment. The diagnosis was psychopathy, according to Hare’s psychopathy checklist.2

Norman showed little improvement over the course of 7 years of behavioral psychotherapy and became less and less motivated. The staff of the forensic psychiatric hospital considered him untreatable and intended to stop all treatment attempts. Norman’s lawyer arranged for an examination by a forensic neurologist, who subsequently found that Norman suffered from severe cortical underarousal, serotonin and MAO abnormalities, and concentration problems.

Treatment with D,L-fenfluramine, a serotonin-releasing drug, was started. (Fenfluramine was voluntarily withdrawn from the US market in 1997.) Acute challenge doses (0.2 mg/kg to 0.4 mg/kg) produced significant dose-dependent decreases in impulsive and aggressive responses. After 1 month, an MAOI (pargyline, 10 mg/kg) and psychodynamic psychotherapy were added. Pargyline produced some normalization of his EEG pattern and was titrated to 20 mg/kg over 5 months. Neurofeedback was started after 2 months and continued for 15 months. His EEG pattern gradually normalized, and his capacity for concentration and attention increased.

Norman continued to receive D,L-fenfluramine and psychotherapy for 2 years, at which point he was discharged from forensic treatment. He voluntarily continued psychotherapy for an additional 3 years and, in the 4 years since his release, has not reoffended.


It is extremely important to recognize hidden suffering, loneliness, and lack of self-esteem as risk factors for violent, criminal behavior in psychopaths. Studying the statements of violent criminal psychopaths sheds light on their striking and specific vulnerability and emotional pain. More experimental psychopharmacotherapy, neurofeedback, and combined psychotherapy research is needed to prevent and treat psychopathic behavior.

The current picture of the psychopath is incomplete because emotional suffering and loneliness are ignored. When these aspects are considered, our conception of the psychopath goes beyond the heartless and becomes more human.


Note to readers- This article was originally published in Psychiatric Times and posted on PsychiatricTimes.com in 2006. Ever since, it has remained one of the best-read articles. We re-publish it here with updates from Dr Martens.



Dr Martens is Chair of the W. Kahn Institute of Theoretical Psychiatry and Neuroscience. He is also Psychiatry Advisor of the European Commission (Leonardo da Vinci) and a member of the Royal College of Psychiatrists.


1. Cleckley HM. Mask of Sanity: An Attempt to Clarify Some Issues About the So-Called Psychopathic Personality. 6th ed. St Louis: CV Mosby Co; 1982.

2. Hare RD, Harpur TJ, Hakstian AR, et al. The revised psychopathy checklist: descriptive statistics, reliability, and factor structure. Psychol Assess. 1990;2:338-341.

3. Martens W. Hidden suffering of the psychopath: new insight on basis of self-reports of psychopaths; 2013. Accessed September 15, 2014. https://www.smashwords.com/books/view/304901

4. Martens WHJ. Antisocial and psychopathic personality disorders: causes, course and remission: a review article. Int J Offender Ther Comp Criminol. 2000;44:406-430.

5. Martens WH, Palermo GB. Loneliness and associated violent antisocial behavior: analysis of the case reports of Jeffrey Dahmer and Dennis Nilsen. Int J Offender Ther Comp Criminol. 2005;49:298-307.

6. Martens WH. Sadism linked to loneliness: psychodynamic dimensions of the sadistic serial killer Jeffrey Dahmer. Psychoanal Rev. 2011;98:493-514.

7. Black DW, Baumgard CH, Bell SE, Kao C. Death rates in 71 men with antisocial personality disorder: a comparison with general population mortality. Psychosomatics. 1996;37:131-136.

8. Martens WHJ. A new multidimensional model of antisocial personality disorder. Am J Forensic Psychiatry. 2005;25:59-73.

9. Raine A, Lencz T, Bihrle S, et al. Reduced prefrontal gray matter volume and reduced autonomic activity in antisocial personality disorder. Arch Gen Psychiatry. 2000;57:119-127.

10. Dolan B, Coid J. Psychopathic and Antisocial Personality Disorders: Treatment and Research Issues. London: Gaskell; 1993.

11. Dolan B. Therapeutic community treatment for severe personality disorders. In: Millon T, Simonsen E, Birket-Smith M, Davis RD, eds. Psychopathy: Antisocial, Criminal, and Violent Behaviors. New York: Guilford Press; 1998:407-438.

12. Sanislow CA, McGlashan TH. Treatment outcome of personality disorders. Can J Psychiatry. 1998;43:237-250.

13. Martens WH. Criminality and moral dysfunctions: neurologic, biochemical and genetic dimensions. Int J Offender Ther Comp Criminol. 2002;46:170-182.

14. Bloom FE, Kupfer DJ, eds. Psychopharmacology: The Fourth Generation of Progress. New York: Raven Press; 1994.

15. Hollander E. Managing aggressive behavior in patients with obsessive-compulsive disorder and borderline personality disorder. J Clin Psychiatry. 1999;60(suppl 15):38-44.

16. Martens WH. Effects of antisocial or social attitudes on neurobiological functions. Med Hypotheses. 2001;56:664-671.

17. Raine A. Autonomic nervous system factors underlying disinhibited, antisocial, and violent behavior. Biosocial perspectives and treatment implications. Ann N Y Acad Sci. 1996;794:46-59.

15 Clues Someone Might Actually Be A Psychopath Or Has Psychopathic Tendencies


by Carina Wolff


It's not uncommon to call someone "psycho," but just like many other mental health terms that get thrown around, the term is often misused. However, there are people who are actually psychopaths, and if you're concerned someone you know might be one, you can look out for certain clues that someone has psychopathic tendencies. Although sometimes used interchangeably with sociopath, a psychopath differs because they don't have a conscience, which can make them hurtful to others and sometimes dangerous — although unlike what the movies would make you believe, not all are violent or murderers.

The term "psychopath" is actually not used in the official Diagnostic and Statistical Manual of Mental Disorders handbook. Instead, the DSM — which is used to categorize and diagnose mental illness — uses the blanket term "Antisocial Personality Disorder."

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"The definition and usage of the term psychopath has morphed over time," says clinical psychologist Dr. Carla Marie Manly over email. "The term psychopath was first utilized around 1900 to describe persons who exhibited little or no sense of ethics or concern for the rights of others. The diagnosis of Antisocial Personality Disorder is used to describe individuals who 'habitually violate the rights of others without remorse.'

If you know someone who continues to hurt others and you're suspicious of their character, you might want to watch out for these 15 clues someone is actually a psychopath or has psychopathic tendencies. Not everyone who does one of these things is a psychopath, but if someone fits each description, you might want to be wary.


They Lack Empathy Altogether


Lack of empathy is the most common feature of psychopaths. "They are people who act recklessly or without sympathy towards others, which often results in chaotic or superficial relationships," says clinical psychologist Devon MacDermott, Ph.D. over email. A study published in the journal Frontiers in Human Neuroscience looked at the brain activity in psychopathic people, and it found that psychopaths do not experience empathy when imagining the pain of others. Even worse, they possibly take pleasure in it.


They're Constantly Aggressive


"Given the lack of emotional awareness and impulsive tendencies, the individual can be volatile," says Manly. "As a result, anger may manifest through irritability and aggressive fights, especially when the individual feels frustrated. As a result, the individual may tend to erupt into a fight or angry outburst when a desired outcome is not achieved quickly."


They're Incredibly Impulsive


"Frequently, they can be impulsive and reckless, jumping into dangerous situations while ignoring the consequences," says psychiatrist Dr. Susan Edelman over email. This isn't the kind of impulsivity that is adventurous or spontaneous. Instead, it's considered "dysfunctional impulsivity," which is characterized by erratic disorderliness, distraction, and inaccurate decision making, according to the American Psychological Association.


They Seek Out Thrills


"People with psychopathic tendencies tend to be adrenaline junkies and will seek stimulation in dangerous ways including risky sexual behavior, activities that could cause bodily harm, or illegal activities," says MacDermott. They are prone to boredom, so they are always looking for stimulation.


They Have Manipulative Tendencies


A psychopath will display patterns of deceiving and manipulating others for profit or even personal amusement. "People with this severe type of personality disorder lack a sense of inner right and wrong," says Edelman. "They don't seem to care about another person’s feelings, so it doesn't bother them to manipulate or deceive others for their own gain. They might trick you with charm, intimidation, or violence."


They Commit Criminal Acts


"Psychopaths tend to be habitual criminals, or they engage in non-criminal behaviors that are generally regarded as unethical, irresponsible, immoral, or in violation of social expectations and norms," says Manly. According to a study published in the journal Legal and Criminological Psychology, psychopaths make up as much as 25 percent of male offenders in federal correctional settings, even though they only account for 1 percent of the general population.

Legal and Criminological Psychology, $160, Amazon


They Turn On The Charm


Don't be fooled by someone's apparent sweetness. "People with psychopathic tendencies can appear gregarious, funny, and charming, at first," says MacDermott. "However, they do not have the genuine warmth and caring to support long-term relationships. They tend to be charming to get what they want from people, not because they actually care about investing in others."


They Have Shallow Emotions


Deeper emotions such as kindness, empathy, compassion, sorrow, remorse shame, and guilt are foreign to the individual who is considered a psychopath, according to Manly. "Shallow, more easily accessed feelings, such as anger, rage, and frustration are often much more accessible to the individual," she says. "The person with ADP may, at times, be able to feign a deeper emotion, but this would be done only on a temporary, superficial level in order to achieve the desired end result."


They Demonstrate Insincere Speech


A person with Antisocial Personality Disorder has a hidden agenda. "Although comments may sound kind and benevolent, the underlying intention is personal gain," says Manly. "For example, a comment such as, 'You are the most beautiful woman!' would be intended to flatter to achieve a personal goal (sex, theft, etc. ) rather than being a sincere, heartfelt comment with no secondary gain involved."


They Avoid Responsibility And Blame Others


Rather than taking responsibility for their actions, psychopaths evade accountability by casting blame on others. "For example, rather than saying, 'I’m sorry that I took your wallet, that was simply wrong of me,' the comment might be, 'I don’t know how your wallet ended up in my closet. You are so forgetful — you must have put it there,'" says Manly.


They Have An Inflated Sense of Self-Worth


Individuals who possess a psychopathic personality usually are narcissistic, arrogant, and dominating. "This population tends to have an exaggerated sense of self-worth and self-importance," says Marc Romano, Psy.D over email. Because of this, they also show a sense of entitlement.


They're Pathological Liars


As part of their manipulative personalities, psychopaths tend to be pathological liars and and masters of deception. "Lying is key to their existence and when caught in a lie, the psychopath will double down," says Romano.


They Exhibit Promiscuous Sexual Behavior


"Impulsive behavior and sexual promiscuity are common among this population," says Romano. Because their personality traits prevent them from having healthy relationships, their sex life is often not healthy either. Research shows that psychopaths tend to have many short-term relationships, but they exhibit promiscuous sexual behavior.


They Don't Have Goals


People who fall into the category of psychopath often have an inability to plan for the future, according to Psychology Today. They fail to set realistic, long-term life goals, and they are carefree about not having any of these plans.


They Live A "Parasitic Lifestyle"


Psychopaths take advantage of others to get what they need out of them. "This can also be referred to as a 'parasitic lifestyle' in which people will persuade or force others to meet their every need without offering anything in return," says MacDermott. "It's an exaggerated version of the person who sleeps on your couch and eats all your food, but never offers to contribute anything to the household and doesn't search for a job."

15 signs that your partner is a psychopath


Man among people Man and woman

In everyday life, psychopaths are called people with an explosive temperament or simply eccentric. But strictly speaking, psychopathy is a personality disorder. And statistically, most psychopaths are men.

They can be extremely charming, accommodating and sociable on the surface, but long-term relationships with them are very toxic for their partners. nine0003

How can we understand that we are dealing with a psychopath and not just a person with a complex character? Of course, only a specialist can make a diagnosis, but here are some alarming signals worth paying attention to.

1. He looks down on you

A psychopath directly or indirectly emphasizes his superiority over a partner who allegedly falls short of his level: “You are stupid and uneducated”, “You are too emotional”, “You are fat and notorious”.

Next to the psychopathic personality, the partner feels like a "junior in rank", worthless and unworthy, whose task is to please and appease his idol. nine0003

2. His declarations of love are quickly replaced by indifference

He can court beautifully, and your honeymoon will be so romantic... But rather quickly he cools down and begins to treat you with disdain. Relationships with a psychopath are like a roller coaster: he either loves or hates, quarrels alternate with stormy reconciliations. Disrespect quickly turns into insults.

For his victim, this situation is truly traumatic and fraught with depression, neurosis, drug or alcohol abuse. And in any case - post-traumatic syndrome. nine0003

3. He does not know how to admit his own guilt

He is never responsible for what is happening and for his actions - others are always to blame. Even when his guilt is obvious, he deftly distorts and presents what happened as an involuntary mistake or joke. Or assures that he was misunderstood. Or that the partner is simply too sensitive. In a word, he does everything to minimize his responsibility.

4. He uses manipulation to win you over

For a psychopath, courtship is only a game or a sport: he seduces with the help of manipulative tricks, in which there is neither warmth nor sincerity. Kindness, attention, care, gifts, travel are just a means for him to get what he wants. He expects that later, when the candy-bouquet period is over, the partner will pay for all this with obedience.

5. One partner is not enough for him.

A psychopath does not know how to build close, sincere relationships, he quickly gets fed up and starts looking for new adventures. This does not mean that he will immediately leave the annoying victim - such people know how to combine several novels at once. nine0003


He reacts aggressively to any criticism

Outwardly, he gives the impression of an imperious, narcissistic and soulless person who does not give a damn about the feelings of others. But how sharply and with what aggression he reacts when he is criticized, questioned or neglected!

The reason is not that he is not confident in himself or needs the approval of others. No, the whole point is that he believes in his superiority and power over others. And therefore, he cannot stand it if someone points out his weaknesses or “wrongly” communicates with him. nine0003

7. It is important for him to feel like a winner in everything

In his mind, the world is divided into winners and losers. And it is very important for him to be among the first in everything, even in small things. This attitude is incompatible with healthy relationships that involve cooperation, compromise, and the ability to repent.

8. Next to him you lose the ability to reason

With a sufficiently long relationship, the psychopath's partner begins to experience cognitive impairment: he may have problems with memory, concentration, attention, motivation and self-organization. He becomes distracted, less effective, and anxiety overwhelms him. nine0003

9. He wants to dominate

The psychopath likes to humiliate, control and devalue others - this is how he asserts his power over you. But he cannot stand it if they try to point out his behavior to him, and falls into a rage. Moreover, he tries to take revenge on the "offender".

10. He often hides the truth

This is another manifestation of his manipulative tendencies. He can only be silent about something or lie to his face. Moreover, a lie can concern both minor trifles and very important things - a child on the side, a permanent partner or marital status. nine0003

11. He has no moral principles

The psychopath has a disdainful attitude towards social norms and moral rules and easily oversteps them. Cheating of all kinds, theft, harassment, intimidation, revenge against those who stand in his way - all means are good for him.

12. He is incapable of deep feelings

On a superficial acquaintance, he can charm and demonstrate sympathy, which he is not really capable of. In communicating with a stranger, a psychopath can prove to be much better than he is used to behaving with a partner - especially if he needs to impress a strong person or cause envy. nine0003

13. He declares himself a victim

This is a typical form of manipulation when psychopaths communicate with an ordinary person who has empathy. They use our capacity for empathy and compassion, portraying themselves as unfortunate victims - and receive forgiveness for any transgressions. This allows them to avoid blame and responsibility and achieve their goals.

14. Kindness and respect are alien to him. ! Please stop lying! Why are you so cruel and rude to me?” nine0003

15. You feel that you will never be good enough

The psychopath is prone to accusing, criticizing and thereby belittling his partner: “You dressed like a walker! You didn't clean the house well! You are so dumb! Don't say a word to you! Think how vulnerable! How annoying!” He interprets any requests or demands of a partner as attempts to control him and perceives with hostility.

About the author: Rhonda Freeman is a clinical neuropsychologist.

Text: Alina Nikolskaya Photo Source: Getty Images

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Psychologists have found that the striatum of psychopaths is 10% larger

Psychologists have found that the striatum of psychopaths is 10% larger - Gazeta.Ru | News



In people with psychopathic features, the striatum is enlarged by 10%, psychologists from the Nanyang Technological University in Singapore found. They told about this in an article in the magazine Journal of Psychiatric Research .

The striatum is an area of ​​the brain, the function of which is the regulation of muscle tone and the functioning of internal organs, various behavioral reactions, encouragement and reinforcement. The striatum is also associated with impulsive behavior.

Earlier observations have shown that people with psychopathic traits have an overactive striatum. Now, researchers, after interviewing 120 volunteers and conducting an MRI scan, found that the more pronounced a person's psychopathic tendencies, the larger his striatum. On average, the striatum of psychopaths was 10% larger than that of people without psychopathic traits. nine0003

“The results of our study help expand our knowledge of what underlies antisocial behaviors such as psychopathy. We found that, in addition to the influence of the social environment, it is important to consider that there may be differences in biology between antisocial and non-antisocial personalities, in this case in the size of brain structures, ”the authors of the work noted.

Perhaps because of the larger size of the striatum, psychopaths require more intense stimulation of it, which pushes them into antisocial behavior, including crime, the researchers suggest. The reasons for the enlargement of the striatum, however, are not yet clear. This may be due to heredity, but further research will be needed to verify this. nine0003

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