Personality disorders: explanations are not excuses
There is a common and serious misunderstanding that happens whenever people discuss evil behavior. I’m keen to clear this up to the degree that I can, because it’s preventing people from understanding each other, people who are on the same side of issues of right and wrong. This is a misunderstanding, not a true philosophical disagreement.
But if you care about moral issues, it’s crucial to get this right.
I've been noticing some people react in a certain way when people point out likely psychopathy or malignant narcissism in other people. I'll give a paraphrased but accurate story example.
Pretend there's a guy named Biff. Biff's friends discover that he's exploited every past girlfriend by running up her credit cards then skipping town. When the women confront him, he laughs and calls them "stupid" for letting their guard down.
The friends also discover that Biff has been convicted of financial and violent crimes. They're disgusted to see how immoral and deliberately cruel he is.
Jane warns others over lunch, "He's dangerous; he's a psychopath."
And then, strangely, John objects. "I'm not going to excuse him or let him off the hook with so-called 'psychopathy.' He's actually evil."
I understand why this happens, but it is a serious misunderstanding. It's nearly a category error.
John's objection is just like saying, "No, that's not a car, that's just an automobile." I trust it's clear what's wrong with this formulation.
The mistake people are making when they say, "No, I won't excuse him with narcissism/psychopathy/borderline. He's just a very bad person," is a definitional mistake. They believe that having a Cluster B personality disorder like narcissism or anti-social personality disorder (sociopathy/psychopathy) is a moral excuse.
It is not. That needs repeating. This is not a moral excuse for wicked behavior. If you believe that it is, you are making a category error.
Instead, psychopathy is a description of a certain kind and level of evil behavior. It is not in opposition to the concept "bad man;" it is a way of describing the concept "bad man."
I think I know where this confusion comes from. We have made mental illness of every sort into a purely medical question. This is a mistake. Being a psychopath is not like a "blameless disability" such as having insulin-dependent diabetes because your pancreas went wrong in childhood. The same can be said for many other kinds of "mental illnesses."
Personality disorders—I don't even like calling them "mental illness" because that invokes the medical sympathy reaction. But it also invokes the confused pushback that is the subject of this post. The pushback is understandable if you mistakenly believe that properly labeling a personality disorder offers a moral excuse; I’d object as well if I thought that’s what was going on. But it’s not actually going on.
People perceive that explaining a wicked woman's behavior by pointing out that she ticks the boxes for malignant narcissism is an act of morally excusing her wicked behavior. It is not; that's a base level misunderstanding.
Personality disorders—remember, these are often ways to describe bad behavior, even though the concept is more than just that—are not medical questions. They are moral questions, mostly. Yes, they’re related to trauma and many other concepts, but for this conversation and these purposes, they evoke moral questions.
At the risk of putting too fine a point on it, consider serial killer Ted Bundy. He was a psychopath.
I'm betting few of you had a negative reaction when I wrote "he was a psychopath." It probably passed you right by because you agree with the obvious consensus. You did not perceive me to be "letting Ted Bundy off the hook," did you?
Neither did the courts. He was executed.
Note this, too: Cluster B personality disorders almost never win the "insanity defense" in court. Did you know that? Why is that? Because the test is a moral one. "Did the accused know the difference between right and wrong, and did he choose to do wrong anyway?" is the legal system's test for the insanity defense.
That means that, for the purposes of the legal system, a malignant narcissist is sane. That is to say, he is fully morally culpable for his actions. He is not disconnected from reality; he is not hallucinating. He is not under a paranoid delusion. He is legally sane, which is to say that he is morally insane, as these sorts of personality disturbances used to be called.
Psychopathy is not a medical question or an excuse, or a "disability" in that sense. It is a moral question. Those who are psychopathic are, by definition, immoral.
There is no conflict.
Addenda
“Psychopath” and “sociopath” are not synonyms for “serial killer.” That is a profound misunderstanding. Only a tiny fraction of those with anti-social personality disorder are serial killers. These conditions are about deranged emotional and moral processing. Physical violence is not part of the diagnostic criteria. It is often there, but it is not necessary for it to be there in order to describe a psychopath.
There are people who will try to use their personality disorder as a moral excuse for their bad behavior. This is not uncommon among borderlines, for example. And there are enablers to these people who cover over their moral crimes by treating the personality disorder as if it were diabetes.
To the extent that that is happening, I object right along with anyone else who is objecting. That is a real problem. I should have framed this essay more as “this not what I personally mean,” and acknowledged this additional problem.
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When identifying someone as a [malignant narcissist | psychopath | sociopath | Cluster B], you're saying, "This person is exceptionally dangerous and cannot be given the benefit of the doubt. This person's defects are calcified and irremediable -- they will not change for any reason short of a major stroke or lobotomy. This person should be never be trusted -- no matter how charming or sincere they may seem -- and instead should be avoided at all costs. And for God's sake, quit electing them to office, idolizing them, or marrying them."
The diagnosis is meant as a WARNING, not as a plea for understanding. Good grief.
I am a therapist who works with people parented or married to Cluster B. I would love a follow up to this.