PSYCHOPATHIC PERSONALITIES. - Thus are understood those abnormal personalities who suffer and cause society to suffer (K. Schneider). In the last century there was frequent discussion of moral insanity (Pritchard), whose authoritative supporters were Carpenter and Maudsley; of manie raisonnante (Pinel), folie lucide (Trélat), and folie morale (Falret). Much emphasis was placed (Magnan) on the nosographic autonomy of such syndromes. Lombroso’s earliest views (1872–85) on constitutional immorality were directly connected with Morel’s doctrine, which placed moral insanity within the framework of degeneration: the born criminal, as the representative of a true mental degeneration, bearing the anthropological stigmata of somatic decline, the visible setting of ethical degradation. After 1885 Lombroso sought to assimilate congenital criminality to a variety of epilepsy, thus asserting an increasingly marked pathological interpretation.
The first to deal systematically with the psychopathology and nosographic classification of psychopaths was J. L. A. Koch, who in 1893 published a careful study with the significant title Die psichopathischen Minderwertigkeiten; for this author, that is, abnormality was equivalent to an impairment, an inferiority: minus habens, abnormal, and psychopath were equivalent terms. In 1913 Jaspers acutely demonstrated the untenability of the position which, until then, had regarded the concept of illness as a value-concept, both in general medicine and in psychiatry: the value-concept of what is pathological thus came to be resolved into a concept of Being, free from value (wertfreier Seinsbegriff). In 1923 Gruhle, in his Psychology of the Abnormal, asserted the clear separation of evaluating (Bewerten) from knowing (Erkennen). For him, psychopath was equivalent to abnormal, without any consideration of the value of the abnormal; thus, in this sense, genius and the criminal would be equivalent. In 1923 Kurt Schneider placed his conception on a much more practical plane, seeking to group together those abnormal individuals with whom the physician has to deal. His definition, reported above, rests on no value judgment, since it admits the possibility that plus habentes, abnormal precisely by reason of their value, may neither suffer nor cause others to suffer, and may therefore not be psychopaths. In terms of Aristotelian gnoseology, the abnormal is a more generic and extensive concept, the psychopath a more specific and comprehensive one. The concept of “norm” (v. BIOMETRIA; NORMOTIPO) includes important philosophical and psychological questions, both as an ideal norm (what ought to be normal) and as a real norm (what is normal), both as an average norm (a general, biological-natural, rational concept, free of contradictions but formal and empty) and as a norm of value (an individual, psychological-human concept, rich in content); these concepts, however, are all relative: for example, the concept of an average norm may be useful only in biological questions and in the natural sciences, while the concept of “norm as value” is useful only in psychological questions and in the sciences of the spirit. K. Schneider seeks to overcome the relativism of the concept of norm by his concept of a “real average norm, without value judgment”; but in this way the individual is considered not in his understandable individual intrinsicness, but in his incomprehensible extrinsicness, that is, he is taken as an average man, not as an individual.
Almost all authors today agree (Müller-Suur) in holding that abnormal personalities are more pronounced quantitative (not qualitative) divergences than those considered variations of a personality within the sphere of the real average norm. The transition between normal and abnormal personalities occurs through successive stages, without clear limits, imperceptibly (at the extremes of a Gaussian curve).
Psychopathic personalities constitute nothing “pathological,” if by “pathological” are understood those psychic disturbances (qualitative abnormalities) conditioned by organic processes, by their functional consequences, and by their outcomes; that is to say, the somatic correlate of psychopathic personalities is not a disease or a malformation; at most, it might be regarded as a quantitative abnormality of structure or function. Classical psychiatry clearly and fundamentally separates abnormal (psychopathic) personalities from cyclothymic and schizophrenic psychoses, which are with good reason postulated as “pathological.” Some English-speaking authors also seem today to be returning to this distinction (Karpman). There are no transitional stages between psychopathic personalities and psychoses, even though a certain constitutional predisposition to the latter cannot be denied (e.g., schizoidism). Abnormal personalities are congenital variations, deriving from a generic, not necessarily hereditary disposition; they are greatly affected by the development and fluctuations of their non-experienced substrate (unerlebi) and by the effect of events charged with emotion (Erlebnisse).
CLASSIFICATION. - Individual human characteristics can be arranged schematically, at least within certain limits, and the various psychopathic types can be derived from their different exaggerations. The classification most widely followed today is that of Schneider, which is unsystematic because he considers the existence of a purely systematic patho-characterology impossible. Schneider describes a series of types that cannot be compared with one another, while admitting the possibility of numerous and manifold combinations among them. It is important to know the descriptive features of p. p., especially for the differential diagnosis from psychoses and therefore for the differing severity of prognostic judgment. At times the differentiation can be extremely difficult, as, for example, frequently occurs with regard to the schizophrenic “defect.”
Schneider distinguishes: 1) hyperthymic psychopaths, simple and “compensated” (the latter seem not to belong among true psychopathic conditions but only among the abnormalities): they are impulsive, lively, active subjects, but negligent and superficial, full of good intentions that will never be put into practice. 2) Depressed psychopaths, with a melancholic and an ill-tempered variant; the latter are cold, suspicious, grumbling, harsh, irritable, dysphoric, at times wicked and malicious. 3) Psychopaths insecure about themselves, a variety not far removed from the preceding one and largely corresponding to Kretschmer’s “sensitives.” This involves inner insecurity, with little self-confidence, accompanied by shyness; often, though not always, the feeling of inadequacy concerns the ethical attitude, with a pronounced sense of self-blame. The following frequently derive from this type of personality: 4) ananancastic, phobic, and obsessive psychopaths (v. psicosi ossessiva): through thoughts, representations, feelings, impulses, and compulsive actions, the fundamental psychopathological character of “compulsion” always emerges, that is, a content of consciousness from which the subject cannot free himself, even while judging it at the same time absurd in its content or at least rigidly dominant without any reason. 5) Fanatical psychopaths, markedly active and expansive personalities; the personal fanatic (querulomaniac) fights for his alleged right, while the fanatic of an idea struggles for his program. There are also calm and taciturn fanatics, detached from reality, eccentric, fantastic, such as certain sectarians (Schneider’s “matte Fanatiker”); in the jealous, personalities that are not merely expansive but more complex (Kretschmer), as also in querulomaniacs, paranoid “developments” may arise. 6) Psychopaths in need of esteem (Geltungsbedürftige): these are personalities who wish to appear more than they actually are. This need for esteem is displayed eccentrically, in order to attract attention, or boasts and fabrications are recounted: this is what used to be called “pseudologia fantastica” and is better designated by the word Renommieren; those who might be called adventurers enact a genuine theatrical role, the one that real life denies them. 7) Psychopaths with labile moods: this involves excessive reactivity in a depressive direction upon a background that is not itself reactively determined; such ill humor, such dysphoria, almost always lies at the basis of excessive drinking, vagrancy (poriomania), and prostitution; the ill humor here is always primary; sometimes such individuals with labile moods are designated as “epileptoids,” but without any justification, indeed incorrectly. 8) Explosive psychopaths: excitable, irritable, hot-tempered personalities, with primitive reactions (Kretschmer). 9) Athymic psychopaths (Gemütlose): these are personalities with little or no sense of compassion, modesty, remorse, or honor; they are often cold, rigid, brutal, cruel, and instinctive; one cannot here speak of “weakness of the moral sense,” understood in the sphere of frenastenias, because such subjects have no congenital intellectual deficits; they are practically inaccessible to every attempt at correction, improvement, or education; it must not be forgotten that, besides criminal athymics (especially sexual ones), there are also social athymics, iron-willed natures that “walk over corpses”; here intelligence is often excellent. 10) Abulic psychopaths (Willenlose): they are easily influenced and receptive and therefore partially re-educable; their social profile is determined by a lack of firmness. 11) Asthenic psychopaths, not in the physical sense but only in the characterological sense; they are subjects who complain of limited powers of concentration and performance, deficient memory, and at times Erlebnisse of depersonalization (the world of perceptions, their own feelings, and their own actions appear distant, unreal, and faded).
Such classifications and typological subdivisions have often been criticized, and often with good reason. Psychopathic types are spoken of as though they were a diagnosis; they are, however, frameworks that highlight only certain particular properties; the individual possesses many other properties, indeed innumerable ones, including some of great importance—for example, ethical properties—which, because they do not interfere with the diagnostic designation, remain in obscurity and unclassified. On the other hand, the typological designation of psychopaths often gives the impression that one can arrive at a “total,” or nearly total, understanding of the individual, whereas the classification is always incomplete and particular and is based on characteristics situated at different psychic depths: using J. H. Schultz’s concepts, one might say that there are psychopaths of the nucleus (Kerupschopathen) and peripheral or framework psychopaths (Randpsychopathen).
A very important conceptual and methodological difference between psychopathic conditions and psychoses lies in the fact that in the latter there is a tendency to disregard the content, the theme, and the individual imprint, in order to penetrate into the structural, the “formal”; in psychopathic conditions, by contrast, what is essential is the content, the quid. And it is precisely in this circumstance that the difficulty of descriptively classifying psychopathic types resides; all the more so because some characterological traits exclude one another, whereas others often coincide: a compensated hyperthymic person cannot be insecure about himself, and a fanatic cannot be abulic, although the two opposites do not logically exclude each other: thus, hyperthymic individuals are not infrequently explosive, and depressed individuals are often asthenic. It is evident that “the immeasurable territory of psychic being, even in its abnormal variants, does not allow itself to be abstractly mastered by any kind of clinical diagnosis, by any system of pathological designations” (Schneider).
Nor should one believe that the typological designation of a psychopath is necessarily an indication of something lasting: anyone may be insecure about himself or in need of esteem in youth and later lose these characteristics or almost completely compensate for them; this often occurs in the case of asthenics.
Few authors have considered which personality traits can be weakened, strengthened, developed, or even formed by Erlebnisse and which cannot; in weaker dispositions (Anlage), the factor of malleability is very pronounced, for example, in insecure, depressed, and asthenic individuals.
Kahn spoke clearly of “psychopathic episodes,” both endogenous and reactive; psychotherapy exerts an effective action upon the latter because it too is an Erlebnis.
Nevertheless, bearing these clinical reservations in mind, typology (and Schneider explicitly recognizes this) can still be usefully employed today despite its limited cognitive value.
MORAL IMPUTABILITY. – For an accurate determination of moral imputability, individual abnormal cases must be considered separately. Abnormalities, in fact, as such, are merely abstractions: in reality there are only abnormal individuals; therefore, except in cases in which the activity of the higher faculties suffers no impairment and those in which this activity is totally disturbed, the degree of imputability in cases of abnormality varies according to the individual patients. The extreme cases, in which imputability remains entire or is completely removed in p. p., are to be regarded as exceptional. Generally, imputability is neither left intact nor annulled: it is merely diminished. The diminution of imputability concerns only acts influenced by the abnormality, and not the others. Moreover, the diminution is to be assessed by considering only the value of the act at the time of the imputability at issue, which may have existed directly and indirectly, both with regard to the abnormality itself and with regard to its effects. The overall moral judgment must also take these responsibilities into account. Pietro Palazzini