Dictators have a need to be respected, to be loved, to be adored. The great difficulty most of these dictators encounter however has been that many people do not like them, do not support them and disagree with what they want to do and what they represent. So, what is a dictator to do? If he is to survive, if he is to carry out his policies, he must re-create himself, paint himself into the picture, create his own cult of personality.

     Studies suggest that there are common characteristics seen in many non-democratic leaders. Death cults, whether the ‘quirky’ such as the Manson Family (see post: Death Cults) or the religious ((see post: The Reverend Jim Jones) are invariably led by demagogues who impose their personalities on their followers. These leaders and many dictators display the many of the signs of six types of ‘personality disorders‘.

     Totalitarian leaders such as Joseph Stalin of the Soviet Union, Muammar Gaddafi of Libya, Adolf Hitler of Germany, Mao Ze Dong of China, Saddam Hussein of Iraq, Juan Peron of Argentina, Kim Jong Il of North Korea (and there are many more) all have some or all of the characteristics of the following ‘disorders’.

     Schizotypal personality disorder is a personality disorder where the person experiences as need for social isolation, has an odd manner of thinking or behaviour, anxiety in social situations and often has unconventional beliefs. People with this disorder are often unable to maintain close relationships. These people are often superstitious and often interpret events as ‘meaningful’ for themselves.They frequently misinterpret situations as being strange or having unusual meaning for them. Paranormal and superstitious beliefs are not uncommon for these people. Anxiety and depression are a common problem.

  Schizoid personality disorder (SPD) is characterized by a lack of interest in social relationships, a tendency towards a solitary lifestyle, secretiveness and emotional coldness.

The Narcissist

      Narcissistic personality disorder (NPD) is a disorder where the individual is excessively preoccupied with issues of personal adequacy, power and prestige. These individuals are seen as egocentric and often as megalomaniacs ( an inflated sense of self-esteem).

     Antisocial personality disorder (ASPD) is characterized by disregard for, and violation of the rights of others. This usually begins in childhood or early adolescence and continues into adulthood.

Anti-Social Behaviour (Vincent van Gogh)

      Paranoid personality disorder is a disorder characterized by paranoia and usually involves beliefs of persecution or beliefs of conspiracy towards the individual and/or his group. There is a general mistrust of those outside of the ‘inner circle’ or ‘tribe’. People with this particular disorder may or have a tendency to bear grudges, suspiciousness, tendency to interpret others actions as hostile, persistent tendency to self-reference, or a tenacious sense of personal right.

Paranoid Behaviour (Vincent van Gogh)

     Sadistic personality disorder is a disorder no longer recognized as a distinct entity by the American Psychiatric Association. But the characteristic of sadism can be said to be a common behavioral disorder characterized by a callous, vicious, manipulative, and degrading behavior expressed towards other people.

Sadism

     Before the development of modern media and communications, emperors, monarchs and ruthless generals used religion as the spring-board to seize and maintain power. In medieval Europe, the dictator could cite the ‘divine right of kings‘ (see future post: The Monarchy of North Korea), in Imperial China, the ‘mandate of heaven‘.

The Coronation of Charlemagne

     The ruler could allow himself to be crowned by religious leaders (Charlemagne, the first ‘Holy’ Roman Emperor) and even declare himself a ‘god-king’ (the Imperial cult of ancient Rome).

The Mandate of Heaven

     Today, cult development depends not just on display and rumour but relies heavily on propaganda and the media, tilted in favour of the cult personality. Throughout history, there have been cults built up around individual leaders using word of mouth, persuasion, coercion and brute force but since the age of modern media (radio, television, rapid transit for mass rallies) there has been a proliferation of personality figures who have emerged.

     Human beings, it has been said, are ‘programmed to worship’, whether it be worship of a god, worship of a teen-age pop star, worship of an ideology or worship of an individual. The personality cult takes advantage of this human predisposition. It is a system in which a leader is able to control a group of people through the sheer force of his or her personality/charisma, where the person is seen as god-like figure and where criticism of that person is generally prohibited depends today so much on the unending bombardment of the masses by state-sponsored media to ensure that the people are given a consistent picture of the leader’s ‘perfection’. The aim of the personality cult is usually to enact radical change within society.

     The individual leader’s image becomes associated with this new set of values or goals that are perceived by the public to be beneficial to the nation’s well-being, even when these ‘values’ or goals have a negative effect on everyday life. Personality cults are maintained through glorification of the leaders often to that god-like status.

The Imperial Cult of Rome

     As far back as ancient Greece, leaders and monarchs developed the theory that the ruler ‘embodied the law’. High profile and showy ceremonies honouring the leaders contributions and achievements, statues and paintings of the leader commemorating events and ‘benevolent’ acts as well as the omnipresent face on the coin, the daily reminder of the man in charge – these are all means used in the past and in the present day for a personality cult to thrive.

     Many political leaders stand out in history as creators of personality cults. Joseph Stalin is perhaps one of the best examples of a leader who set out with the precise intention of creating a cult in his own name. Joseph Stalin (1879-1953) took on the name ‘Stalin’ (‘Man of Steel‘), changing his name from the Georgian Dzugashvili at the age of 34. He was the son of a shoemaker and, as a young man, studied for the priesthood but was expelled from the theological school for insubordination.

Joseph Stalin

     In Stalin’s early years he was continually in trouble with the local authorities. Stalin accepted grandiose titles such as ‘Father of Nations’, ‘Brilliant Genius of Humanity’, ‘Great Architect of Communism’, ‘Gardener of Human Happiness’) and rewrote Soviet history, giving himself a more significant role in the revolution of 1917. He insisted that he be remembered as one with ‘the extraordinary modesty characteristic of truly great people’.

     Towns, villages and cities were renamed after the Soviet leader and the ‘Stalin Prize‘ and the ‘Stalin Peace Prize‘ were named in his honor. Statues of Stalin depict him at a height and build greater than his true physique with photographic evidence suggesting that he was between 5 ft 5 in and 5 ft 6 in (165–168 cm). 

     Stalin had his name included in the new Soviet National Anthem and he was the focus of literature, poetry, music, paintings and film that exhibited fawning devotion. At times, Stalin was credited with almost god-like qualities, including the suggestion that he single-handedly won the Second World War.

Massive Starvation in the Ukraine-1933

     Once firmly in power, Stalin carried out purges, killing off potential rivals. Terror was used to keep the population ‘in line’. Historians estimate that nearly 700,000 people (353,074 in 1937 and 328,612 in 1938) were executed over this two-year period with the majority of victims ordinary Soviet citizens – workers, teachers, priests, soldiers, pensioners and beggars. Shortly before, during and immediately after World War II, Stalin ordered deportations altering the ethnic map of the Soviet Union. Between 1941 and 1949 nearly 3.3 million were deported to Siberia and the Central Asian republics. Almost half of the resettled population died of malnutrition and disease. ‘State-organized’ famine has been alleged, ordered by Stalin (Holodomor famine) to eliminate Ukrainian nationalism in 1932–1933 when between 2.2 million and 5 million died of starvation. Ethnic Poles and Germans were also targeted and eliminated.

Statue of Stalin-Larger than Life

     Even today, nearly 60 years since he died, many elderly men and women reject or rationalize any and all evidence of Stalin’s ‘errors’ and hang on to their belief in Stalin’s godlike powers. Some people claim that they used to believe in Stalin but lost their faith gradually, like groupies who eventually outgrow their youthful infatuation with a band. And there is evidence that significant numbers of Russians remain ‘proud’ in some sense of Stalin, though this ‘pride’ in Stalin appears to have much less to do with Stalin’s actual cult of personality than with Stalin’s supposed achievements as a leader.

     Perhaps it was in the years that he spent in the priesthood that Stalin learned something about ‘following without questioning’. Trouble with authority was evident in his youth and, once he sensed that power was at hand, Stalin immersed himself into the cult of personality.

     Was Stalin narcissistic? He did change his name to the ‘Man of Steel’ and stuck it on town and cities. He built  larger than life images of himself and spread them throughout the country.

Katyn Massacre-Thousands of Polish Soldiers Murdered

      Was Stalin paranoid? Did he have ‘anti-social’ characteristics? He was always ‘looking over his shoulder’ and eliminated rivals with a fury.

     But, like every demagogue who wants the world to forget his dark side, Stalin built monuments, bridges, forced modernization and populated the far reaches of the Soviet Empire. Even today, some people still have fond dreams of the long-lost days of Stalinism.

     *Personality cults: subject of research for the novel The Tao of the Thirteenth God – Amazon Kindle.

     Various studies have examined the subject of drug abuse among physicians and have shown that, in general, the rate of illicit drug use is less among doctors than the general public.  The rate of abuse of prescription drugs however is considerably greater for physicians, up to five times higher than in the general population. Up to 15 percent of all health care professionals will battle substance abuse at some point in their careers. Is this due to stress? Overwork? Easy access to addictive substances? In the field of medicine, there is one speciality that is especially prone to substance abuse and it is abuse of the most powerful, dangerous and addictive substances known.

Drug Addiction

     The speciality field is anesthesia (the specialists who put you to sleep for surgery) and the substances most commonly abused are narcotics (morphine and its derivatives). Needless to say, anesthesia can be a very stressful job. Knowing what type of medication is needed, how much is needed and during what point in the surgery it should be administered are all important factors that can determine life, significant brain injury or even death. No patient is the same. There are no ‘recipes’ for drugs except according to weight, age, cardiac condition, kidney condition, drugs the patient already is taking…The list goes on and on.

     Anesthesia is similar to piloting a large aircraft (but without any auto-pilot or computer to back you up): a period of boredom (hopefully) while the patient is safely anesthetized (the aircraft is in flight) with a period of ‘terror’ at the beginning (take-off), as the patient is put to sleep and another period of ‘terror’ at the end (landing), as the patient is brought out of anesthesia.

Prescription Drug Abuse

     But with all these powerful drugs at hand (barbiturates are also commonly abused by anesthetists) and all the stress of the job, it is perhaps surprising that more of these specialists don’t become addicts. Although anesthetists make up only 3 percent of all specialists, this group accounts for 20 to 30 percent of drug-addicted doctors.

     Several organisations recognize the problem of addiction among physicians and realize that certain groups, such as anesthetists, are more susceptible to this problem. Despite campaigns as well as teaching of the risks of addiction early in medical training, the difficulty with substance abuse among doctors remains a problem.

Anesthetists at the Head of the Operating Table

     In the operating room, anesthetists usually wear short sleeves. The needle tracks of injection sites would be difficult to hide but these specialists are not just experts at putting a patient to sleep. They are also  experts at finding and accessing veins for drug administration – between the toes, on the leg or the inside of the thigh. Drug addiction is an ‘occupational hazard‘ among this group of physicians but a hazard that can have catastrophic effects for the patient under care.

Demerol – An Intravenous Narcotic

     Is an anesthetist on drugs (The ‘High’ Doctor) still capable of performing his/her work? That depends on whether the addict has become tolerant to his ‘drug of choice’, when he took it, the type and sub class of drug used…This list goes on and on, too. But the short answer is ‘No’. No physician, dependent on drugs is safe to ‘pilot the airplane’. His response time and ability to make a decision may be unreliable. His judgement may be impaired.

     And even when giving a drug to himself, does the doctor, at that point, really know what drug he has just taken? Drugs in the operating room are administered by vein, many do not contain preservatives, the vast majority have no color. In the bottle and in the syringe (except for the labelling, if it is done correctly), they all look the same. They all look like water.

The American Society of Addiction Medicine

     What follows is a true story: He was a young man (J.R. – not his real identity), a specialist in anesthesia, out of training no more than 5 years. The patients who met him, loved him and had great confidence in his skills. The surgeons and nurses knew him well (or so they believed). J.R.’ s behaviour seemed normal. At times, however, he would be very talkative, at other times, there was only silence behind the curtain of sterile sheets that separated the surgery from the head of the table where the patient lay.

     At the end of one very long week, J.R. ‘disappeared’ before his patient was transferred to the recovery room (an unusual event in the practice of anesthesia) and no body knew where he was. Just by chance, one of the nursing staff , searching for a mop in a closet, found J.R, still breathing, slumped in a corner, a needle in his arm.

     J.R., medical expert, knowledgeable of all the risks and possible complications inherent in anesthetic drugs, had mistaken his substance of choice (fentanyl, a narcotic – see post: A Basketful of Narcotics) with a paralysing agent (pancuronium). Immediately upon injecting the wrong agent, J.R. realised that he had made a mistake but it was too late. The paralysis seized his body and he stopped breathing.

     J.R. was one of the lucky ones. Nursing staff and fellow anesthetists came quickly to the scene and he was resuscitated.

     Both medications in this particular circumstance are the color of water. Both are given intravenously. Each one can be easily confused with any number of anesthetic agents. And each one alone can be deadly.

     But how can a physician in this position of authority and responsibility, in the presence of and watched by fellow staff members, obtain the drugs (narcotics, in the case of J.R.) without his co-workers knowing? Is there not a system, an accounting of drugs used? Is there not a way of measuring how much narcotic was used for the patient, when it was given and how much of the open ampoule that the drug was packaged in was left over?

     The answer is ‘Yes’. But, as with most systems, there are always ways to ‘outsmart’ it.

     *The drug-addicted physician: subject of research for the novel Whip the Dogs – Amazon Kindle

     Hippocrates of Cos (460 BC – c370 BC) was a physician of ancient Greece and is considered the father of western medicine. The ‘oath’ attributed to him was first written in Ionic Greek and elaborates on the duties and responsibilities of doctors both to the practice of medicine as well as to patients. One of the most important guidelines of the oath is to treat your patients but, above all,  ’Do no harm‘.

Hippocrates

     This document has been used in altered or abbreviated form throughout the centuries to signify commitment by the practitioner but, even having taken an oath, not all physicians were able or even desired to do what was best. There have been many reasons why this ‘oath’ has not always been followed. It is not that doctors do not want to do the best for their patients (most do). But historically, the science and art of medicine has not always had the correct answers and, despite the best of intentions, the practitioner sometimes did more harm that good.

     The history of western medicine involves four phases, each distinguished by a different intellectual framework that guided medical practice. The first phase involved supernaturalism (mysticism, superstition, and religion), lasting from about 3000 BC to 450 BC. Medical practice during this period, consisted primarily of attempts to manipulate or invoke supernatural forces.

Supernaturalism and Magic

     The second phase, during the rise of the Greek civilization was characterized by theory (450 BC. to the 1500s) a time when perhaps the first seeds of scientific medicine began to grow.

     The third phase was the beginning of true science, characterized by original research (1500s to late 1800s).

     The fourth phase is the era of true objective science and technology (late 1800s to the present).

     It was Hippocrates who is credited for first rejecting ‘supernatural forces’ as the basis for medical practice, bringing to an end the domination of medicine by mysticism, superstition, and religion. Hippocrates and others of his time developed theories that diseases had natural, discoverable causes and that treatments should be based on an understanding of these causes.

The Four Elements

     In ancient Greek thought, the natural world consisted of four elements, each with specific properties: earth (dry and cold), fire (dry and warm), air (moist and warm), and water (moist and cold). All matter, including living tissues, consisted of combinations of these basic elements.

     Based on their understanding of the nature of matter, they identified four bodily fluids, or humors, each with the same properties as the corresponding four elements: black bile (earth), yellow bile (fire), blood (air), and phlegm (water). Black bile came from the spleen and stomach; yellow bile, from the liver; blood, from the heart; and phlegm, from the brain. There persisted an element of supernatural in this early medical practice (see post: The Colors of Faith).

     Equilibrium among the humors was essential for good health. Disease occurred due to unhealthy winds or climate, bad waters, or places that caused ‘corruption’ of one of the humors, any disturbance of this ‘humoral’ equilibrium. Restoration of the humoral  balance was the focus of treatment.

Ready for Your Enema?

     Because ‘accumulation of blood and phlegm in the joints caused arthritis’, this disease was treated by enemas and suppositories;  pneumonitis with hemoptysis (blood in the spit) was treated by letting blood from the arm veins (phlebotomy or ‘blood-letting’) until the patient was as bloodless as possible, and wounds were treated by enemas and fasting (see the story of Dr. Linda Hazzard below).

Phlebotomy (Blood-letting) in Ancient Greece

     It is unlikely that many patients benefited from treatment based on these humoral theories. Most were likely made worse by these ‘treatments’. When Alexander the Great became ill in 323 BC (about fifty years after the death of Hippocrates) after an evening of eating and drinking, his physicians provided care. Despite their treatment, Alexander’s condition deteriorated steadily and he is reported to have said shortly before his death, ‘I die by the help of too many physicians’.

Alexander the Great

     Needless to say, results like this led to widespread doubt concerning the efficacy of medical practice. Cato (234-149 BC) urged Romans to ‘beware of doctors’ for they bring death by medicine.’ The Romans decorated monuments to Alexander the Great with the inscription ‘it was the crowd of physicians that killed me’.

Cato

     Galen (129-200 AD), probably the most influential physician in history (see post: A Basket-Full of Narcotics) was born in Pergamon, originally a Greek city, then a Roman city during the rise of the Roman Empire, and then a Turkish city after the fall of Rome. Galen studied Hippocratic medicine at the Aesculapian in Pergamon, then visited other medical centers in the empire. Finally, at the age of twenty-eight, Galen was appointed surgeon for the gladiators of Pergamon.

     He later moved to Rome where he became Emperor Marcus Aurelius‘s physician and advisor. Galen prided himself on his clinical observations, learning anatomy from wounds and deaths among the gladiators but, for the first time in medicine, he conducted original, planned investigations. His conclusions, however, did not always make sense. One of his most illogical and dangerous recommendations was that hemorrhage should be treated by bleeding.

Galen

     Galen’s reputation and extensive writings helped to pass his ideas and practices on through the centuries but instead of following his ideas of observation or experiment, those who followed him expanded the humoral theories to explain personality characteristics; moods and emotions; health and disease; and the roles of the moon, the planets Jupiter, Mars, and Saturn, the stars, and the Apostles Mark, Peter, John, and Paul.

     During the black-plague epidemics in Europe (fourteenth century), doctors treated plague victims by bleeding, purging, and blistering. In the Middle Ages, physicians performed dissections guided by simultaneous readings from Galen.

The Black Plague

     These early years of medicine were not ones that would have provided great confidence to the sick or the dying, certainly no more confidence than could be provided by the priest or the magician.   Even today, however, for many different reasons, the ‘practitioners’ of medicine can often do more harm than good, provoke more pain than healing, cause death rather than preserve lives.

     The following are examples of just a few of the ‘qualified’ practitioners who have provided the world with modern-day ‘Death by Physician’.

Dr. Herman Webster Mudgett

     Herman Webster Mudgett (1861 –  1896), also known as Dr. Henry Howard Holmes, was one of the first documented American serial killers.  At the time of the 1893 World’s Fair in Chicago, Holmes opened a hotel which he had designed and built for himself specifically with murder in mind. Dr. Mudgett had graduated from the University of Michigan Medical School in June 1884 and even while enrolled, he had begun his criminal career. Mudgett stole bodies from the anatomy laboratory, disfigured the bodies, and claimed that the people were killed accidentally in order to collect insurance money from policies he took out on each deceased person.

Dr. Linda Hazzard

     Linda Hazzard (born 1867  - (died of self-starvation) 1938) was a physician who was killing her patients by exhausting diets. Hazzard was the first doctor in the Unites states of America to earn a medical degree as a `fasting specialist’, fasting having previously been considered a quacky. ‘Fasting For The Cure Of Disease’ was Hazzard’s own book which was published, promoting fasting as a cure for virtually every disease.

Dr. Marcel Petiot

     Marcel André Henri Félix Petiot (1897 – 1946) was a French doctor, convicted of multiple murders after the discovery of the remains of 23 people in his home in Paris during World War II. During the First World War, Petiot volunteered for the French army, was wounded and gassed and exhibited symptoms of mental breakdown. Following this first war, Petiot entered the accelerated education program intended for war veterans and completed medical school in eight months.

Dr. Shiro Ishii

     Shirō Ishii (1892 – 1959) was a Japanese microbiologist and physician and the lieutenant-general of Unit 731, an outfit of the Japanese Army, specializing in biological warfare and responsible for human experimentation and other crimes of war during Japanese occupation of China in the Second World War. Some historians estimate that tens of thousands died as a result of the bio-weapons deployed.

     His unit also conducted physiological experiments on human subjects, including  live,  non-anesthetized dissections, forced abortions, and simulated strokes, heart attacks and hypothermia. Dr.Ishii and his team negotiated and received immunity from prosecution in exchange for their disclosure of germ warfare data based on human experimentation. He died at his home of throat cancer at the age of 67.

Dr. Harold Shipman

     Harold Frederick Shipman was born into a working class family in England on June 14, 1946. Dr. Shipman had a thriving general practice with many of his patients, the elderly and frail. By the time he was 55 years old, Shipman had been convicted of several murders of his own patients (by narcotic overdose) and had been given 15 consecutive life sentences  plus four years for forging the will of his last victim, Kathleen Grundy.

John Bodkin Adams

     John Bodkin Adams (1899 – 1983) was an British general practitioner, convicted of fraud and suspect as a serial killer. Between the years 1946 and 1956, more than 160 of his patients died in suspicious circumstances, 132 of whom left him money or items in their wills. He was tried and acquitted for the murder of one patient in 1957. Another count of murder was withdrawn by the prosecution in what was later described as ‘an abuse of process’. Adams was found guilty in a subsequent trial of 13 offences of prescription fraud, lying on cremation forms, obstructing a police search and failing to keep a dangerous drugs register. He was removed from the Medical Register in 1957 and reinstated in 1961 after two failed applications.

      There have been many other physicians known to have ‘done away’ with ‘bothersome’ patients as well as qualified doctors who have chosen career paths outside of medicine, paths which also led to the deaths of many people.

Dr. Salvador Allende

     Salvador Allende Gossens (1908 –  1973) was a Chilean physician and politician and the first democratically elected Marxist to become president of a country in Latin America. Allende himself was not obviously responsible for deaths of his countrymen (or his patients) but his life was ended when the presidential palace was stormed by revolutionaries (backed by the C.I.A.), beginning years of dictatorship in that country.

     Ernesto ”Che” Guevara ( 1928 – 1967) was an Argentinian Marxist, physician, author, guerilla leader and military theorist who became a prominent of Castro’s Cuban Revolution While attempting to export marxist revolution to the rest of Latin America, Guevara was eliminated (by the C.I.A., again) in Bolivia in 1967.

Ernesto (Che) Guevara

     Ayman Mohammed Rabie al-Zawahiri ( born June 19, 1951) is an Egyptian physician and surgeon (an ophthalmologist or eye-surgeon), Islamic theologian and, since the death of Osama bin Laden, current leader of al-Queda.

     Bashar Hafez al Assad ( born 11 September 1965) is the current President of Syria and Regional Secretary of the Syrian Arab Socialist Ba’ath Party. Assad graduated from medical school in Damascus then completed specialty training in ophthalmology at the Western Eye Hospital in London.

     Seyyed Mohammad Reza Khatami (born 1959) is an Iranian politician and nephrologist (kidney specialist).

     He was the first Secretary-General of the Islamic Iran Participation Front, the largest Iranian reformist party.     He is also the former deputy speaker of the Iranian parliament, the grandson-in-law of the late Ayatollah Ruhollah Khomeini and the younger brother of the fifth Iranian president Mohammed Khatami.

Ayman Mohammed Rabie al-Zawahiri (with Osama bin Laden)

     The ‘Hippocratic Oath‘ is really more myth than fact in today’s world. At no time in my training nor in any of my colleagues’ training was any one actually obliged to recite his/her dedication to the principles of the profession.

     But, recited or not, as a physician, the principles of the Hippocratic Oath have always been accepted by medical students and graduate physicians as a ‘given’. It’s just that, as in any field, there will always be a few bad ‘outliers’, some who follow a ‘hippocritic’ rather than the Hippocratic oath.

Bashar Hafez al Assad

     Perhaps it was Matthew Prior (1664 – 1721), English poet and diplomat who put it simply and said it best:

     ’Cured yesterday of my disease, I died last night of my physician’.

     *Physicians ‘gone bad’: subject of research for the novels The Tao of the Thirteenth God – Amazon Kindle; Whip the Dogs – Amazon Kindle.

     Anybody who writes (or anybody who delves into the creative arts) realizes how satisfying, frustrating and how addictive the process of putting pen to paper (or today, fingers to keyboard) can be. Perhaps, it is because of this ‘yearning to write’ that, there is such a long history of substance abuse among writers. In some cases, it remains controversial whether the author him/herself actually indulged in drug use or whether the writer simply wrote about it, planting a character or two into the uncomfortable world of addiction.

Edgar Allan Poe

     Edgar Allan Poe is one writer where controversy still stirs around the possibility that he may have used drugs. Most agree that the man did drink alcohol heavily although the term ‘heavily’ may not have been appropriate for the times. Poe’s death was dramatic, sudden and puzzling. He was found delirious on the streets of Baltimore and died shortly thereafter (October 7, 1849).  Some believe that, aside from a regular heavy use of alcohol, Poe was also addicted to laudanum (tincture of opium) which, at that time was available without prescription as a cough suppressant.

      One commentator of the time said: ‘I incline to the view that Poe began the use of drugs in Baltimore, that his periods of abstinence from liquor were periods of at least moderate indulgence in opium’.

Laudanum

     Charles Lutwidge Dodgson (Lewis Carroll), the author of Alice’s Adventures in Wonderland, Alice Through the Looking Glass as well as a large number of entertaining, strange and wonderful poems was sickly as a child (whooping cough) and also suffered from a speech impediment (stammer).

     In later years, he suffered from hearing loss, migraine headaches and epilepsy. Dodgson is known to have used laudanum (as did Poe) and possibly also belladonna (deadly nightshade) for his headache. Belladonna, taken in adequate doses, can produce hallucinations, much like Alice experienced during her adventures (see post: Mother Nature’s Psychedelic Roadside Drug Store).

Lewis Carroll

       Sir Arthur Conan Doyle (an ophthalmologist, by training) wrote about his character, the detective Sherlocke Holmes who, aside from cigarettes, cigars and pipes was a regular user of cocaine (in a ‘seven percent solution’) as well as the occasional user of morphine.

     Robert Louis Stevenson suffered from tuberculosis for most of his life and died of a brain hemorrhage at the young age of 44 years. ‘The Strange Case of Dr. Jekyll and Mr. Hyde’ made him his fortune and he bought a South Seas island to which he retired to spend the rest of his days in quiet, writing, taking opium and whiskey. Others claim that he was a ‘rampant cokehead’, writing his hugely successful novel in under one week.

Sir Arthur Conan Doyle

     There is evidence that William Shakespeare may have at least experimented with drugs. Residues of cocaine and myristic acid, also known as tetradecanoic acid (a plant-derived (nutmeg) hallucinogen) in clay-pipe fragments have been retrieved from the bard’s Stratford-Upon-Avon home. Marijuana residues were also present. His ‘Sonnet 76‘ is interesting for the implications of  experience with drugs…’compounds strange’ and ‘noted weed’:

“Why with the time do I not glance aside
  To new-found methods, and to compounds strange?
                                                             Why write I still all one, ever the same,
                                                             And keep invention in a noted weed,
                                                             That every word doth almost tell my name.”

William Shakespeare

     But Shakespeare lived 400 years ago and the others lived in the nineteenth century, times when these drugs were not controlled substances and users usually had no idea that taking these medications could have harmful side effects. It is likely that many, if not all, of these writers used (or abused) alcohol but with all the education on drug abuse in our society today, are things any different?..Yes. Things are different. Substance abuse among writers is probably much more rampant than it was during the times when many of the ‘better’ drugs were harder to find.

     Stephen King, hugely successful as a writer of horror, admitted to cocaine use especially between the years 1979 and 1987  which explains the history of his constant bloody nose and stories which always seem to involve a psychic or a mad man.

     William S. Burroughs, author of ‘Naked lunch’ and ‘Junkie’ was an abuser of eukodol (an opioid, today’s oxycodone) and heroin.

Nutmeg

       Jack Kerouac, author of ‘On the Road’ and ‘The Subterraneans’ (written in under four days!) was a renowned user of  Benzedrine, an amphetimine which would explain his ‘rocket-jet writing style’ and the subject matter of his books, often involved ‘drug-fuelled cross-country road trips’.

          Ken Kesey, is best known for his book about a mental institution (where he actually spent some time as a patient), ‘One Flew Over the Cuckoo’s Nest’. Kesey was a graduate of Stanford University’s Creative Writing Program and was also part of the government-financed (CIA) MKULTRA experiments, which tested the effects of mind-distorting drugs like LSD, mescaline, and pot.

Stephen King

These drug ‘studies’ were focused on finding ‘mind-control’ and ‘truth’ drugs. Towards the end of the program (1957 to 1964), the study focused on schizophrenia research under the direction of  Dr. Donald Ewen Cameron  of the Allan Memorial Institute of McGill University in Montreal, Canada.

      Aldous Huxley wrote ‘Brave New World’ and was known for his interest in mysticism, parapsychology and ingesting mescaline. On his death-bed at age 69, unable to speak, he wrote a note to his wife asking for an intramuscular injection of LSD. His book ‘Doors of Perception’ is thought to have influenced the band ‘Jim Morrison and the Doors’ (‘Break on through to the other side’).

Ken Kesey

     But of all the modern writers, it is Hunter S. Thompson who stands out as the ‘ultimate drugged writer’. Known for his sarcastic commentaries and pointed critiques, Thompson wrote ‘The Rum Diary’ and ‘Fear and Loathing in Las Vegas’, most of which concerns on-going drug-crazed experiences: ‘Hallucinations are bad enough. But after a while you learn to cope with seeing things like your dead grandmother crawling up your leg with a knife in her teeth. Most acid fanciers can handle this sort of thing.’

Hunter S. Thompson

     Thompson was a life-long user of LSD, mescaline, cocaine and alcohol. He loved guns and committed suicide  by shooting himself in the head on February  20, 2005, age 67.

     Being an author can be stressful, even dangerous…Any of you reading this thinking about writing a book?

     *Drug addiction: subject of research for the novel Whip the Dogs – Amazon Kindle.

     ’Madness without delirium‘, ‘moral insanity‘ – these are just two of the terms that had been used until the late 1800s to describe the personality without a conscience, the personality with a lack of social responsiveness. The term ‘psychopath‘ was first coined by a German clinician and since then has been used as the description of the criminal with violent, unstable behaviour.

A Psychopath? Not Really.

     The term ‘sociopath’, first used in the 1930s, is considered by some to be a synonym for psychopath, by others to describe an individual with behaviours which are perhaps less extreme. Today, the same definitions and uses of the terms ‘psychopath’ and ‘psychopathy‘ are not accepted by all researchers. Most agree that psychopathy is a personality disorder characterized by a pattern of disregard for the feelings of others and often the rules of society.

     The psychopath has a lack of empathy and lack of remorse as well as very shallow emotions. However there is no consensus about the symptom criteria for psychopathy, and no psychiatric or psychological organization has sanctioned a diagnosis of ‘psychopathy’. Many researchers do not consider the terms antisocial personality disorder (ASPD) and psychopathy as being synonymous.

     ASPD refers to broad behavioral patterns based on clinical observation, whereas psychopathy assesses character as well as behavior.

A Psychopath?

     The definition of ASPD is so broad that it is estimated that between 50-80% of male inmates qualify as meeting its criteria whereas, Hare estimates that only 11-25% of male inmates meet the criteria for psychopathy.

     To make the understanding of these two terms even more confusing, the current edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders Text Revision (DSM-IV-TR), published in 2000 describes antisocial personality disorder (ASPD), which is characterized by a long-standing history of criminal and often physically aggressive behavior and refers to it as synonymous with psychopathy. Much research, however, shows that measures of psychopathy and ASPD overlap only moderately.

     The characteristics of the psychopathic personality was first described systematically by Medical College of Georgia psychiatrist Hervey M. Cleckley in 1941 who described psychopathy as consisting of a specific set of personality traits and behaviors. According to Cleckley, a psychopath was superficially charming, tending to make a good first impression on others and often striking observers as remarkably normal.

     This disarming presentation hides the reality of the psychopathic individual who is self-centered, dishonest and undependable and will, at times, engage in irresponsible behavior for no apparent reason other than the sheer fun of it.   The psychopath is devoid of guilt, empathy and love and will have only casual and callous interpersonal and romantic relationships. They may offer excuses for their reckless actions blaming others, are often impulsive and rarely learn from their mistakes or benefit from negative feedback.

Hervey M. Cleckley

     With this definition in mind, psychopaths seem overrepresented in prisons, many studies indicating that as many as 25 percent of inmates meet the diagnostic criteria for psychopathy. But other research also suggests that a sizable number of psychopaths may be walking among us in everyday life. There may actually exist ‘successful psychopaths‘, people who attain prominent positions in society, such as politics, business and entertainment. Most psychopaths are male and the ‘condition’ of psychopathy is present in both Western and non-Western cultures.

     As recently as the mid-1970s, almost 80 percent of convicted felons in the United States were being diagnosed as sociopaths/psychopaths. In 1980, psychologist Robert Hare of the University of British Columbia devised the Hare Psychopathy Checklist (revised five years later and now known as the PCL-R) which has become a standard ratings tool most often used in forensic settings to assess psychopathy, using a forty point scale. Using the PCL-R, one study suggested that 1-2% of the general US population score high enough to be considered potential psychopaths.

Robert Hare

     There is little evidence of a cure or effective treatment for psychopathy. No medications can instill empathy, and psychopaths who undergo traditional talk therapy often simply become more adept at manipulating others and more likely to commit crime.

     According to Dr. Hare, psychopathy stems from as yet unconfirmed ‘genetic neurological predispositions and as yet unconfirmed social factors in upbringing’. Although the term ‘psychopath’ is not officially used in diagnostic manuals (DSM-IV), it is still used by many mental health professionals and by the general public as well as by the press and in fictional portrayals (ex Hannibal Lecter).

     Although psychopathy is associated with and in some cases is defined by conduct problems, criminality or violence, many psychopaths are not violent, and psychopaths are, despite the similar names, rarely psychotic.

University of British Columbia, Vancouver, Canada

     Unfortunately, the label of ‘psychopath’ has both political and social implications. By definition, a psychopath is an individual who is likely beyond rehabilitation – today, an accusation which is ‘politically incorrect’.

     In the United States,  high PCL-R scores have been used as an argument to support the death-penalty. In the UK, there is debate whether some individuals with personality disorders (such as psychopaths) should be detained even if they haven’t committed a crime.

Hannibal Lecter

     The Hare Psychopathy Checklist, Revised (PCL-R) is a clinical rating scale consisting of 20 items. Each of the items in the PCL-R is scored on a three-point scale according to specific criteria through file information and an interview of the patient. A value of 0 is assigned if the item does not apply, 1 if it applies somewhat, and 2 if it fully applies.

     These scores are used to predict risk for criminal re-offence and probability of rehabilitation.

     There are similarities or ‘cross-overs’ with other psychiatric conditions, such as PCL-R Factors 1a and 1b being seen also in narcissistic personality disorder and histrionic personality disorder.

     PCL-R Factors 2a and 2b are strongly correlated to antisocial personality disorder as defined in the DSM-IV.

     The PCL-R was developed primarily as an assessment for convicted criminals. As with any ‘interview’ device, the quality of ratings may depend on how much background information is available, whether the person being rated is honest as well as the objectivity of the interviewer.

The Hare Psychopathy Checklist, Revised (PCL-R)

Factor 1: Personality ‘Aggressive narcissism’

a. Glibness/superficial charm
b. Grandiose sense of self-worth
c. Pathological lying
d. Cunning/manipulative
e. Lack of remorse or guilt
f. Shallow affect (genuine emotion is short-lived and egocentric)
g. Callousness; lack of empathy
h. Failure to accept responsibility for own actions

Factor 2: Case history ‘Socially deviant lifestyle’
a. Need for stimulation/proneness to boredom
b. Parasitic lifestyle
c. Poor behavioral control
d. Lack of realistic long-term goals
e. Impulsivity
f. Irresponsibility
g. Juvenile delinquency
h. Early behavior problems
i. Revocation of conditional release

Traits not correlated with either factor
a. Promiscuous sexual behavior
b.Many short-term marital relationships
c. Criminal versatility
d. Acquired behavioural sociopathy/sociological conditioning (Item 21(d): a newly identified trait i.e. a person relying on sociological strategies and tricks to deceive)

     The PCL-R is referred to by some as the ‘gold standard‘ for assessing psychopathy. Thirty out of a maximum score of 40 is recommended as the cut-off for the label of psychopathy (Hare, 2003), although there is little or no scientific support for this as a particular break point.

     In research, a cut-off score of 25 is sometimes used. This threshold varies between jurisdictions as well –  the UK has used a cut-off of 25 rather than the 30 used in the US.

     Other studies attempt to describe ‘psychopaths’ according to their major characteristics, separating them into 4 groups (primary and secondary first described by Cleckley in 1941):

     Primary psychopaths do not respond to punishment, apprehension, stress, or disapproval. They are able to inhibit their antisocial impulses most of the time, not because of conscience, but ‘because it suits their purpose at the time’. Words do not seem to have the same meaning for them as they do for the general population. At times, it seems they are unable to grasp the meaning of their own words (‘semantic aphasia‘). They don’t follow any life plan and are incapable of experiencing any genuine emotion.

Unable to Resist Temptation

     Secondary psychopaths are risk-takers but are also more likely to be stress-reactive, worriers, and guilt-prone. They expose themselves to more stress than the average person and are as vulnerable to stress as the average person. They are daring, adventurous, unconventional people who began playing by their own rules early in life. They are strongly driven by a desire to escape or avoid pain, but are unable to resist temptation. As their anxiety increases toward some forbidden object, so does their attraction to it. They live their lives by the lure of temptation.

     Both primary and secondary psychopaths can be subdivided into:
     Distempered psychopaths fly into a rage or frenzy more easily and more often than other subtypes. Their frenzy will resemble an epileptic fit.
     They are also usually men with incredibly strong sex drives, capable of astonishing feats of sexual energy, and seemingly obsessed by sexual urges during a large part of their waking lives. Powerful cravings also seem to be in their character, cravings such as drug addiction, kleptomania, pedophilia, any illicit or illegal indulgence. They like the endorphin ‘high’ of excitement and risk-taking (see post: Your Personal Narcotic).

     Charismatic Psychopaths are charming, attractive liars. They are usually gifted at some talent or another, and they use it to their advantage in manipulating others. They are fast-talkers and possess an almost demonic ability to persuade others out of everything they own, even their lives. Leaders of religious sects or cults (see post: The Reverend Jim Jones) might be psychopaths if they lead their followers to their deaths. This subtype often comes to believe in their own fictions and are irresistible.

     Popular misperceptions surrounding psychopathy persist (possibly due to the condition’s depiction in the media):
1. All psychopaths are violent – not true.

Ted Bundy

     Psychopathy is a risk factor for future physical and sexual violence and at least some serial killers—Ted Bundy,John Wayne Gacy and Dennis Rader, the infamous “BTK” (Bind, Torture, Kill) murderer—have manifested numerous psychopathic traits, including superficial charm and a profound absence of guilt and empathy.

     Most psychopaths, however, are not violent, and most violent people are not psychopaths. In the days following the horrific Virginia Tech shootings of April 16, 2007, many newspaper commentators described the killer, Seung-Hui Cho, as ‘psychopathic’. Yet Cho exhibited few traits of psychopathy. Those who knew him described him as markedly shy, withdrawn and peculiar.

Seung-Hui Cho

2. All psychopaths are psychotic – not true.
     In contrast to people with psychotic disorders, such as schizophrenia, who often lose contact with reality, Psychopaths are almost always rational in contrast to people with psychotic disorders (ex schizophrenia) who often lose contact with reality.

     The psychopath is well aware that his ill-advised or illegal actions are wrong in the eyes of society but shrug off these concerns. Some serial killers referred to by the media as psychopathic, such as Charles Manson (see post: Death Cults) and David Berkowitz, displayed striking features of psychosis rather than psychopathy.

Charles Manson

     For example, Manson claimed to be the reincarnation of Jesus Christ, and Berkowitz believed he was receiving commands from his neighbor Sam Carr’s dog (hence his adopted nickname ‘Son of Sam‘).

3. Psychopathy is untreatable – not necessarily true.  
     Psychopaths are often unmotivated to seek treatment but some studies suggest that psychopaths may benefit as much as non-psychopaths from psychological treatment. Even if the core personality traits of psychopaths are exceedingly difficult to change, their criminal behaviors may prove more amenable to treatment.

David Berkowitz

     Is there a difference between psychopathy and sociopathy? Are psychopaths and sociopaths two different disorders?

     Some literature says that these two conditions are similar yet somewhat different. Some studies place the prevalence of ‘sociopathy’ at 4% in our society. This compares with a prevalence for anorexic eating disorders of 3.43% (nearly epidemic); schizophrenia occurs in only about 1% of the population; the rate of colon cancer in the United States, considered ‘alarmingly high’ is about 40 per 100,000 – one hundred times lower than the rate of antisocial personality.

     The high incidence of sociopathy in western (and likely, every) modern society has a profound effect on the rest of us who must live with them or, at least, have them live among us. Most people, however, know nothing about this disorder and, if they do, they think only in terms of violent psychopathy – murderers, serial killers, mass murderers – people who are conspicuous, who break the law and who, if caught, will be imprisoned, perhaps even executed by our legal system.

     The following, according to one article, is a comparison of the characteristics of the psychopath and the sociopath.
                                                    Psychopath                                                          Sociopath

Social relationships            unable to maintain normal relationships         appear normal in relationships Tendency to violence            yes                                                                                 yes 
Behaviour                          erratic                                                                          controlled
Suffers from                       antisocial personality disorder                         antisocial personality disorder
Criminal behaviour             erratic-leave clues and evidence                          well-planned-clues rarely left 

     Psychopaths often live at the fringes of society, are often extremely disorganized and are unable to maintain normal relationships with family, friends or co-workers. 

     Sociopaths, in contrast, can be obsessively organized and normal in their social relationships and caring towards their parents. A sociopath would likely live an outwardly normal life in a regular neighborhood and appear to blend in well with society.
     Psychopaths are often unable to hold down a steady job and house whereas sociopaths often have very successful careers and try to make others like and trust them.

     The sociopath is able to understand human emotions quite well but is unable to experience them. This allows the sociopath to be master manipulators of human emotions.

     Violence by a psychopath is erratic and unplanned and after the erratic act, psychopaths  generally leave behind a large trail of clues. On the other hand, sociopaths may take years to plan acts of violence and revenge, making it difficult to catch them. Each step in the violent act of the sociopath is carefully planned, their crime often undetected.

ASPD?

     Psychiatrists often don’t distinguish between psychopaths and sociopaths but rather label a person with antisocial personality disorder (ASPD) with, perhaps the subclassification of ’sociopath‘ (if their mental condition is a result of mainly social conditions such as abuse during childhood) and ‘psychopath‘ (if the condition is mainly congenital).

     If there are true differences between these two ‘conditions’ then there certainly are similarities as well.

      According to some therapists, both sociopaths and psychopaths face medical disorders that can be treated or alleviated if properly diagnosed, the treatment involving both psychotherapy as well as proper medication.
     In both situations, signs of the disorder begin to establish and surface at around fifteen years of age. The presenting symptom may be excessive cruelty to animals followed by lack of conscience, remorse or guilt for hurtful actions to others later on stage.

Animal Cruelty

     There may be an intellectual understanding of appropriate social behaviour but no emotional response to the actions of others.

     Psychopaths (perhaps the more severe form of the same disorder?) may also face an inability to form genuine relationships, and may show inappropriate or out of proportion reaction to perceived negligence.

     But why do these people exist? Is their behaviour an illness/a disease? Can this type of murderously depraved behaviour be biologically based?

     There is evidence that problems in brain structure and chemistry do play a part. Most experts agree that there is no neurological ‘litmus test’ for psychopathy. At King’s College London, scientists claim to have found the strongest evidence yet that psychopaths have abnormalities in key areas of their ‘social brains’. The researchers looked at MRI brain scans of 44 male violent offenders (murderers and rapists), 17 fitting the diagnosis for psychopathy.

King’s College, London

     The prisoners with psychopathic traits had significantly smaller amounts of grey matter in regions associated with processing ‘empathy, moral reasoning and ‘self-conscious’ emotions, such as guilt and embarrassment’. Other studies have implicated abnormalities in the amygdala (the area associated with aggression), lesions in the orbitofrontal cortex as well as in the white matter connecting the two brain regions.

     Genetics may also play a role. One gene in particular has been implicated (MAO- A), which produces an enzyme that breaks down serotonin, a neurotransmitter which affects mood and can have a calming effect.

The Amygdala-Associated With Aggression

     Named the ‘warrior gene‘, it has been theorized that the calming effects of serotonin may not always be effective in people born with a variant of this gene. Some researchers postulate that the brains of psychopaths may be wired for rewards.

     Brain scans show that people with high levels of ‘impulsive antisociality’ show greater activity in parts of the brain related to anticipating and expecting rewards. If those rewards don’t come nearly as frequently as expected, the psychopath becomes more aggressive, more frustrated and more alienated toward the world.

     Other studies suggest psychopaths’ brains have an enhanced ability to sense certain emotions — in particular, fear. They seem better able to pick up cues of vulnerability or weakness, making them, in a sense, a natural-born predator.

A Man With the ‘Warrior Gene’?

     Certainly in modern times (and probably throughout human history), psychopaths/sociopaths have been tormenting our societies.

     During the Second World War, German Nazi and Japanese military physicians carried out cruel ‘experiments and research’ on prisoners, documenting their findings in scientific fashion for the purpose of ‘discovery’ and ‘curiosity’.

     At Auschwitz, under the direction of Dr. Eduard Wirths, selected inmates were subjected to various experiments which were supposedly designed to help German military personnel in combat situations, to aid in the recovery of military personnel that had been injured, and to advance the racial ideology backed by the Third Reich.

Auschwitz

     Unit 731 was a biological and chemical warfare research and development unit of the Imperial Japanese Army that undertook lethal human experimentation during the Second Sino-Japanese War (1937–1945) followed by World War II. This ‘medical’ unit was responsible for some of the most notorious war crimes carried out by Japanese personnel.

     The atrocities committed by the commander Shiro Ishii (see post: Death by Physician) and others under his command in Unit 731 included alive and awake dissection of prisoners (including pregnant women, impregnated by the doctors themselves) and amputation then reattachment of limbs to other parts of the victim’s body.

Nazi ‘Experiments’

     Some prisoners had parts of their bodies frozen and thawed to study the resulting untreated gangrene. Some victims were used as living test cases for grenades and flame throwers. Others were injected with strains of diseases (disguised as ‘vaccinations’) to study their effects.
     Male and female prisoners were deliberately infected with syphilis and gonorrhea through rape, then ‘study’ of their disease carried out.

Unit 731 ‘Experiments’

     More recent, in 2011 and 2012, are the cases of Canadian Luka Magnotta and Norwegian Anders Breivik.

     Nicknamed the one newspaper as the cannibal killer, Luka Magnotta (not his real name but rather one of several aliases) was said to have been inspired by a Jack the Ripper-style slaughter video game starring Christopher Walken.  

     Walken played a cop named Vince Magnotta in the 1996 game Ripper. Luka, a 29 year old gay porn ‘star’, adopted the same surname when he changed his name from Eric Newman in 2006. 

Luka Magnotta

     The game starts with emails sent to a newspaper from a serial killer addicted to butchering his victims. Luka Magnotta allegedly murdered his Chinese boyfriend, Jun Lin, with an ice pick in his Montreal apartment then dismembered the body, mailing one foot and one hand to two federal Canadian political parties and the other foot and hand to two private schools in Vancouver. The torso of his victim was discovered in a dumpster near his apartment.

On July 1, 2012, Canada Day (the country’s national holiday), a severed head was discovered in a Montreal urban park.

     Magnotta fled Canada and, after an international alert, was arrested in Berlin and returned to Canada.   A few years back, Magnotta posted a video on You-Tube of footage of him carrying out strangulation and suffocation of several kittens.

     Magnotta is awaiting psychiatric assessment and trial but has already submitted a plea of not guilty on murder charges.

Ripper Video Game

     Another modern-day (possible) psychopath is the anti-Islam militant Anders Behring Breivik arrested in Norway for the killing of 77 people on July 22, 2011. 

     Breivik had admitted (with pride) to the bombing of the government’s headquarters in Oslo in  July, killing eight people, before gunning down 69 and injuring a further 242 (all victims mostly teenagers), at a summer camp of the ruling Labour Party.

     He however, denied criminal guilt and subjected the country to a trial during which the court had to rule on both his guilt, and his sanity. Breivik attempted to use the trial as a microphone for his ideology, keeping Europe ‘white’ and free from Islam.

     The question of guilt was not an issue as he admitted to the murders but it was Breivik’s sanity which had been, from the outset, the central question the court was obliged to answer. A number of forensic and prison psychiatrists had told the court that they believed that  Breivik was not psychotic and therefore accountable for his actions.

Anders Behring Breivik

     However two people (the authors of the first psychiatric assessment) disagreed, stating that the man was psychotic at the time of his crimes and that he suffered from paranoid schizophrenia.

     Prosecutor Svein Holden stated that, given there were still doubts about his insanity, Breivik should be placed in psychiatric care and not sent to prison. Breivik himself called psychiatric care ‘a fate worse than death’. If convicted of murder as a sane individual, Breivik would face a maximum prison sentence of 21 years under Norwegian law. Commitment to psychiatric care would mean Breivikcould be confined for a long time, perhaps for the rest of his life. The legal system in Norway is scheduled to make a decision in July or August 2012.

     These are all cases of murderous individuals in modern times.

     But were the Nazi doctors in the German concentration camps and the Japanese doctors of Unit 731 true psychopaths? Or were these men simply being led along by ‘group think’ or ‘crowd psychology‘ (see post: The Demagogues-How Do They Do It?). Would they have behaved in a similar way if there had been no war?

     Luka Magnotta certainly seems to fit the criteria for a psychopath. His psychiatric assessment is pending as of June 2012.

Breivik’s Fascist Salute at the Start of Court

     Anders Breivik had a well thought out plan but allowed himself to be easily caught. At this point in time, there does not seem to be full agreement as to whether this man is sane or not, whether he is a true psychopath or really psychotic.

     Finally, is there really a difference between a psychopath and a sociopath? Perhaps one is only a more extreme form of the other.

     And are these two disorders (psychopathy and sociopathy) really different presentations of ‘antisocial personality disorder’ as defined in the DSM-IV?

     More precise definitions may possibly be helpful in treatment for the more extreme cases or may even signal that any attempt at treatment or rehabilitation would be futile.

     But for the population threatened by these individuals, for the victims of their crimes, definition is, more often irrelevant.

     For an interesting discussion on the absence of empathy ( a hallmark of the psychopath), click on the link below.  

     Zero Degrees of Empathy  

     *Psychopathy and sociopathy: subjects of research for the novel Whip the Dogs – Amazon Kindle; 
The Tao of the Thirteenth God – Amazon Kindle.