tic and intriguing psychiatric diagnoses is that of “Antisocial personality disorder”. Those with this diagnosis have the broad psychological tendencies of psychopaths. It includes psychopaths, together with others less extreme. Using the popular tool, the “Hare Psychopathy Checklist”, not all those diagnosed with “Antisocial personality disorder” would score high enough to count as psychopaths.
People with this diagnosis are often said to “lack a conscience”. This claim raises more questions than it answers. There are so many different things, some or all of which might be missing. They might lack empathy (the ability to imagine how others feel). Or they might sometimes harm people, out of a lack, not of empathy but of sympathy: they can imagine how their victim feels but do not care about it. Or they might lack feelings of guilt. Or they might lack certain moral concepts, such as cruelty or selfishness. Or they might lack a conception of the sort of person they are, or lack values that would shape a conception of the sort of person they want to be.
Because I am intrigued by these issues, I am taking part in a team project looking at the “lack of conscience” in two groups of people. One group, in a secure hospital, is made up of people having the diagnosis of Antisocial personality disorder. The other group is made up of neurological patients with the diagnosis of Fronto-temporal dementia, a group who at some stage in the development of their dementia may exhibit antisocial behaviour. My part of the study involves interviewing members of these two groups about their moral outlook, trying to find out what sort of conscience they do or do not have.
The study is not finished, so there are as yet no results that have any kind of scientific status. But, speaking unscientifically, in the interviews with the “Antisocial personality disorder” group, I am overwhelmingly struck by the terrible childhoods so many of them seem to have had. The stories are of rejection, denial of love, humiliation and denigration, violence or sexual abuse. Some of these horrendous childhood experiences took place in the family. Others took place in the public institutions into which, in Britain, children are (in the euphemistic phrase) “taken into care”. Of course, perhaps not all these stories are true. Those with Antisocial personality disorder have a reputation for being skilful deceivers. But the psychiatrists in the hospital think that perhaps eighty per cent of the patients had terrible childhoods.
I will not quote any of the patients I have interviewed. To discuss the issues raised, I will take the case of someone who, while never actually given a diagnosis of psychopathy or of Antisocial personality disorder, would fit one of these categories. This is a real case, and the person in question had a childhood not unlike that of many of my interviewees.
C. The Case of Mr. H.
Mr. H had an unhappy childhood. His father was strict and had a terrible temper. He was a “demon” about punctuality. He insisted on silence in the family. The children never dared speak in his presence unless spoken to, and were not allowed to call him anything less formal than “Father”. When he wanted his son, he never called him by name, but always whistled for him in the same way he called for the dog. The father often beat the dog, his wife, and each of his children. As a child, Mr. H was once given 230 strokes of the cane by his father. In later life, he said he remembered seeing his drunk father rape his mother.
Mr. H grew up with a very rigid personality. As an adult, he was obsessed with cleanliness, passionately hating any untidiness or dirt. He was also obsessed with wolves, sometimes thinking of himself as a wolf, and calling his Alsatian dog “Wolf”. He took the dog for exactly the same walk every day, throwing a stick for it at exactly the same place. Any suggestion of varying such routines made him agitated and angry. He hated being left alone at night, and hated the moon because he thought it was dead. He was obsessed with his own possible death from cancer, wh