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The Dartmouth
April 17, 2024 | Latest Issue
The Dartmouth

Unmasking Psychopathology: Q&A with Professor Janine Scheiner

Janine Scheiner is a psychology professor currently teaching Psychology 52.01, “Developmental Psychopathology,” a course that introduces childhood psychopathology from a developmental perspective. Since 1989, she has worked as a clinical psychologist, conducting psychological assessments and providing consultants for families. This week, the Mirror interviewed Scheiner to unmask the sociopathic and psychopathic condition.

What is the distinction between a sociopath and a psychopath?

JS: There is no distinction. They are the same. They are two different terms for the same problem.

What are the characteristics of a sociopath or a psychopath?

JS: A lack of empathy for others and a belief that the rules don’t apply to them.

How does one diagnose a sociopath or a psychopath?

JS: Based on their history. There are some norm reference instruments, too — for example, Hare’s Psychopathy assessment. You can actually scale the number of deviant events against their history and the quality of their intrapersonal relationships, and so it is mostly through history that we are able to establish that this trajectory for psychopathy exists.

Since diagnosis is based on history, how early can you diagnose a sociopath or a psychopath?

JS: Eighteen. The diagnosis does not pertain to anyone under 18. The diagnosis for someone who behaves that particular way but is younger than 18 is called conduct disorder. That has the same qualities ascribed to it as adult psychopathy, but they are kids so the language is looser to allow for resiliency and developing out of that trajectory.

How many sociopaths and psychopaths are undiagnosed?

JS: I think what your question really means is: Are there people who are out there who are psychopaths who are functioning in ways where we don’t know that they are psychopaths? That’s absolutely the case. Many of them are very successful. People think that if you are in jail it’s because you are a psychopath, but actually if you are in jail it’s because you are disenfranchised. You don’t have the money for a lawyer, and you’re usually high in both anxiety and depression and also have some of the manifestations of psychopathy but not necessarily what we think of a classic psychopath. You have probably been following what has been happening in Uber and the #MeToo campaign, so you can start to imagine that some of those individuals like Harvey Weinstein might be considered sociopaths or psychopaths, right? But because they are successful, they were sheltered. Yes, there are psychopaths that are running corporations potentially, but because of their resource base and their sophistication at managing the system, they don’t get arrested. So they are not identified as such.

What are the causes of sociopathy or psychopathy?

JS: We don’t know. We know that physiologically, psychopaths are different. They have what we call the callous-unemotional trait, which is that they are unable to empathize with other people’s perspectives so they are interpersonally exploitative, and they tend to be Machiavellian in the way they approach things. That’s one characteristic. Another characteristic would be cruelty and aggression, but it is mostly the callous-unemotional piece that seems to be a driver. Physiologically, when you look at the brain, the amygdala, which is the thing that fires when you are anxious, is smaller in a number of people with psychopathy. So there also may be a biological vulnerability to psychopathy when there’s reduced volume of the amygdala.

What research is currently being done on sociopathy or psychopathy?

JS: We are always trying to treat them. Right now, we are looking at restorative justice models because we haven’t really had a lot of luck just warehousing people. If you are talking about what do we do with people in jail, we deal with almost always their co-occurring substance use or mental health issues — a lot of times both. If you are just dealing with a straight up sociopath, we tend to just hyper structure those individuals and we don’t really know what to do to create that empathic connection. Restorative justice models have become more popular. Those are models that seek to bring the community together and for the individual to engage in a process of reparations and apologizing for what they have done. I think especially using that model with younger kids who have conduct disorder before they crystallize fully into adult psychopathy, that can be useful. I think restorative justice models can be helpful, and of course, if we could figure out a way to increase the activity of the amygdala somehow, that could also potentially increase the capacity for empathy, but we don’t know how to do that at all, yet.

Why do you think sociopaths or psychopaths are so often portrayed in horror films and fiction?

JS: Because in order to engage in those horrific acts you have to be pretty blunted emotionally. They are choosing people where it could read as possible based on people who have done such things in the past, like Jeffrey Dahmer, who ate people that he killed. Somebody like that has to have just an incredible numbing process internally so that they are so unemotional that they are able to do these egregious things. The rest of us couldn’t conceive of it. Just thinking about it makes us want to vomit probably. So that is why they choose those people. Also, Charles Manson is another example of a guy who besides being, I think, clearly psychotic, just was very callous, very unemotional, killed people, talked about it the way we would talk about the ice cream flavor we chose. That does tend to be the prototypic presentation of a sociopath. To be fair, that is true, except that some of them work for IBM, some of them run major conglomerations. Maybe they are not eating little boys, but maybe they are sexually abusing women.

Do you think there is a problem with portraying these conditions in horror films and fiction?

JS: The problem with horror films is when scary things are connected with sexual behavior. That happens a lot in horror films: Teenage girl makes out with teenage boy, then a scary thing happens. What I don’t like personally is the linking of violence to sexual arousal in horror films. If they left out the sexual piece, I think it would be much healthier. I think some people really like scary films, and that’s cool. I don’t think they’re aggrandizing Jason with his hockey mask. I think people are afraid of that. When horror films conflate, as they often do, violence with emerging teen sexuality — and they do that a lot — I think that is not healthy. I think that can create an unhealthy message in society to confuse sexual arousal with fear. That’s a big problem, but that’s not one people talk about just about ever.

How do these conditions relate, if at all, to borderline personality disorder?

JS: Well, they are different disorders. With borderline personality disorder, the problem is difficulty modulating emotions. Sociopaths are actually quite different because they generally do hyper-manage their emotions. If you are a successful sociopath, you are not blowing up and going crazy. Those are the people that are in jail, but they are not good sociopaths because they get jacked up and dilated and dysregulated. If you study real sociopaths — like this guy who killed a bunch of sorority women — very calm. I would say that although people think of borderlines as just a mess emotionally, it’s not the case that they are going to be planful, proactive murderers, typically. They are going to commit more crimes of passion. Crimes are planned when you are a sociopath.

Is there anything you would like to add?

JS: I think the main thing that I want to say is what is interesting about this topic is we can’t predict violence. The one question you didn’t ask me about is: How can we tell when someone is going to be violent? The answer is: We can’t. We cannot predict violence. That’s really frustrating. We can’t tell who is going to be the next person to shoot a bunch of people in Las Vegas. I think that’s a really scary thing for people.

This interview has been condensed and edited for clarity and length.

Correction Appended (Nov. 4, 2017):

The title of the Nov. 1, 2017 article "Unmasking the Psychopath: Q&A with Professor Janine Scheiner" was updated to "Unmasking Psychopathology: Q&A with Professor Janine Scheiner" to better reflect the contents of the interview.