55 pages • 1 hour read
Robert HareWithout Conscience: The Disturbing World of the Psychopaths Among Us
Robert HareNonfiction | Book | Adult | Published in 1993A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
Chapter 10-EpilogueChapter Summaries & Analyses
Chapter 10 Summary: “The Roots of the Problem”
Hare states that the traits of psychopathy emerge at an early age. Evidence suggests that most parents of psychopaths are aware of their child’s issues before they start school. Childhood psychopathy is characterized by habitual lying, lack of empathy, defiance of authority, and antisocial behavior, including stealing, vandalism, arson, aggressive behavior, truancy, cruelty to animals, and sexual behavior.
Hare recounts letters he has received from the desperate parents of young psychopaths. One mother reported that her five-year-old daughter had attempted to flush their kitten down the toilet on more than one occasion and was cruel to her baby brother. By the time her daughter was 13, she was often truant, sexually active, and repeatedly stole money from her parents.
Hare asserts that the Diagnostic and Statistical Manual of Mental Disorders does not include a condition that adequately encompasses the traits of psychopathic children and adolescents. Instead, the DSM lists a range of “Disruptive Behavior Disorders” (158): attention-deficit hyperactivity disorder, conduct disorder, and oppositional defiant disorder. While these conditions include some of the characteristics consistent with psychopathy, none of them provides the full picture. For example, although conduct disorder entails violating societal norms and the well-being of others, it does not involve the requisite grandiosity or a lack of empathy and remorse.
Hare describes a research project in which the Psychopathy Checklist was applied to a group of young male offenders aged 13-18. Over 25% fulfilled the diagnosis criteria, and the average overall score was higher than in studies on adult offenders. Thirteen-year-old Jason had one of the highest scores. He came from a stable family background and had no neurological issues. His crimes before the age of six included theft, breaking and entering, and harming younger children. Jason possessed the same characteristics as adult criminal psychopaths, except he talked more openly about his antisocial attitudes and beliefs. He admitted that he enjoyed committing crimes, did not care how his parents felt, and was often able to talk his way out of punishment.
Many people are reluctant to place the “pejorative label” of psychopath on children. Hare agrees that incorrect diagnoses can have a devastating impact on individuals’ lives. However, he argues that as psychopathy can be identified in childhood, early intervention is crucial. Too often, unhelpful treatment programs target individual undesirable behaviors rather than the entire condition. Furthermore, some professionals assume behavior traits are a response to the child’s environment, such as poor parenting.
Hare warns of a dramatic rise in drug-related and violent crime among juveniles. Offenders are increasingly younger, such as a four-year-old girl who killed her twin-baby brothers after one of them accidentally scratched her. The author suggests that working out why some psychopaths become violent criminals while others become “reasonably productive member[s] of society” is key to combating this trend (165).
The author outlines the ongoing debate about whether psychopathy is caused by “nature” or “nurture.” Some researchers believe that the disorder is genetic or biological, while others suggest that an unfavorable early social environment creates it. Sociobiological research argues that psychopathy is a form of “reproductive strategy” to ensure the continuation of the human race. The psychopathic tendency to form many brief sexual relationships fulfills the unconscious urge to pass on one’s genes by having many children. The ability to charm and manipulate others plays a crucial role in securing new sexual partners. Another biological theory is that psychopaths’ brains develop unusually slowly, leading them to exhibit childlike traits such as impulsivity and selfishness. Research has also raised the possibility that dysfunction in the frontal lobes of the brain causes psychopathy. Scientists have noted similarities between the brains of psychopaths and patients who have frontal lobe damage, such as poor executive function, shallow emotions, impulsivity, a lack of patience, aggressiveness, and antisocial behavior.
In assessing the “nature” argument, Hare asserts that there is little evidence to support the notion that early experiences such as trauma or abuse create psychopathy. He provides the example of “adorable, terrifying Tess” (170), an angelic-looking six-year-old whose therapy sessions were recorded by psychologist Ken Magid. Tess’s parents locked her in her room at night, as she had repeatedly harmed her baby brother, punching him in the stomach and banging his head on the floor. Tess calmly told Magid how she planned to kill her mother and brother with knives and described how she liked to hurt and kill animals. She and her brother were adopted, and their parents provided a loving, stable home, but, as babies, they were sexually and psychologically abused by their biological family. Magid argued that Tess was an example of the behavioral issues that occur when children fail to bond with their parents in infancy. However, Hare disagrees with this viewpoint, arguing that other case studies disprove this link. The author points out that attachment theories are popular, as they offer a catch-all explanation for most disorders. However, a failure to bond with parents is more likely to be “a symptom of psychopathy” than the cause (172). Hare argues that attachment theories increase the distress of loving parents who are made to feel responsible for their child’s disorder.
Ultimately, Hare suggests that the origins of psychopathy lie between these two camps, involving “a complex—and poorly understood—interplay between biological factors and social forces” (172). He acknowledges that while social factors and parenting do not create psychopaths, they can influence the way psychopathy expresses itself. For example, a psychopath raised in a nurturing environment is likely to become a white-collar criminal or subcriminal. Meanwhile, a child with the same characteristics raised in an unstable environment is more likely to commit violent offenses, and a minority become serial killers. At the same time, Hare emphasizes that even the best social conditioning will not create empathy or a conscience in psychopathic individuals.
The author concludes by asserting that a “camouflage society” increasingly allows psychopaths to flourish. Criminal gangs provide an ideal environment for those with psychopathic traits, and gang members have become role models for children from unstable or deprived backgrounds. Hare argues that society increasingly tolerates, encourages, and rewards psychopathic traits, meaning that genuine psychopaths often go undetected.
Chapter 11 Summary: “The Ethics of Labeling”
The Hare Psychopathy Checklist is a valuable tool for parole boards when judging a criminal’s likelihood of reoffending if released. Hare emphasizes the disastrous consequences of parole mistakes with the example of Carl Wayne Buntion. Buntion received a fifteen-year sentence for sexual assault but was released by a Texas Parole Board in 1990 after serving only fifteen months. Weeks later, he killed a police officer. The author speculates that Buntion was likely a psychopath, and if properly assessed, his release would likely not have been approved. Psychopathy diagnoses are also useful in classifying prisoners, determining appropriate security levels, managing treatment, and preparing the staff who interact with psychopaths.
Hare stresses the unprofessional nature of “long-distance” psychopathy diagnoses that do not involve a thorough clinical assessment. For this reason, the author declined to respond when CBS approached him during the Persian Gulf War, asking his opinion on whether the Iraqi President Saddam Hussein was a psychopath. However, Professor of Psychiatry Dr. Jerrold Post testified to the U.S. Senate that Hussein had the personality disorder malignant narcissism. Based on this diagnosis, Post incorrectly predicted that Hussein would withdraw from Kuwait before President Bush’s deadline. Texas psychiatrist Dr. James Grigson is another example of the dangers of long-distance diagnosis. Hare explains that, in Texas, a key factor in a jury’s decision to give a death sentence for murder is the probability that the offender will commit further violent crimes. During Texan trials, Dr. Grigson consistently offered the hypothetical opinion that defendants would commit further crimes. This expert opinion was offered with no clinical assessment of the subjects or proper diagnostic procedure. Dr. Grigson’s testimonies resulted in 69 death sentences. Consequently, he became known as “Dr. Death.”
Hare argues that, when properly used, his Psychopathy Checklist can minimize diagnostic errors in the criminal justice system. However, the checklist can be misused. He gives the example of forensic psychiatrist “Dr. J.” As an expert witness, Dr. J. testified that, according to the Hare Psychopathy Checklist, an offender was a psychopath and, therefore, likely to violently re-offend. However, the defendant’s lawyer approached Hare for an independent assessment of the offender. Two of Hare’s colleagues assessed the defendant and concluded he was not a psychopath. Hare explained to the court that Dr. J. had not followed the correct procedures when using the Hare Psychopathy Checklist.
Chapter 12 Summary: “Can Anything Be Done?”
Hare outlines why there is currently no effective treatment for psychopathy. Firstly, successful psychotherapy requires patients to actively engage and want to get better. Psychopaths lack this motivation as they do not want to change and see no benefit in conforming to society’s rules. Thus, many only “go through the motions” of therapy (196), deceiving therapists into believing they have improved. While group therapy is an integral part of most prison treatment programs, studies suggest that it makes the behavior of psychopaths worse. Psychopaths who had participated in group therapy were found to be four times more likely to violently re-offend after release than other offenders. Meanwhile, psychopaths who did not participate were less inclined to violence after release. The author suggests that group therapy provides psychopaths with greater insight into the vulnerabilities of others, enhancing their gift for deception and exploitation.
Hare asserts it could be possible to modify psychopathic behaviors such as impulsivity and aggression if caught early enough. However, the author asserts that psychopaths will only submit to treatment if they believe it benefits them in some way. Hare describes his development of a government-sanctioned treatment program for violent psychopathic offenders in Canadian prisons. The program focuses on convincing subjects that their behaviors are not in their best interests and introducing methods to meet their needs in more socially acceptable ways. However, the author acknowledges that such programs can only be administered in prison.
Chapter 13 Summary: “A Survival Guide”
Hare emphasizes that psychopaths are adept manipulators, and even psychiatric experts can be taken in by them. However, awareness of certain warning signs may help individuals to protect themselves.
Psychopaths often rely on nonverbal “props” such as flamboyant hand gestures, intense eye contact, or a charismatic presence. Hare, therefore, advises focusing on what individuals say and not how they look or sound. He also recommends remaining alert when entering new relationships, particularly if someone seems “too good to be true” (211). Vigilance is particularly important in “high-risk” venues, such as singles’ bars, social clubs, and tourist spots where psychopaths often target the lonely. It is also helpful to understand one’s weaknesses, as psychopaths are attuned to finding and exploiting them. Another tip is to ask new acquaintances questions about their background and attempt to verify the answers. The author describes meeting the new romantic partner of a friend. Although the man claimed to have graduated from the same university as Hare, he became evasive when questioned about his time there. It emerged that the man was lying and was wanted for international fraud.
Hare states that the spouses and parents of psychopaths can only focus on damage limitation. He advises seeking professional advice from an experienced therapist and joining support groups. He also recommends establishing and sticking to clear behavioral ground rules. For example, refusing to bail one’s child or partner out of financial or legal trouble. At the same time, it is important to accept that there is little one can do to change a psychopath’s personality traits. Most importantly, victims should not blame themselves for the psychopath’s behavior.
Epilogue Summary
Hare concludes the book by emphasizing the need for more research. He points out that psychopathy is an under-researched topic, considering the disorder causes more societal harm than all other mental disorders. Rather than wasting resources prosecuting, incarcerating, and unsuccessfully trying to rehabilitate criminal psychopaths, society must focus on early intervention to socialize them.
Chapter 10-Epilogue Analysis
In Chapter 10, Hare delves further into The Relationship Between Psychopathy and Social Manipulation by investigating the disorder’s origins and manifestation in early life, particularly as they impact others. Hare’s summary of the nature versus nurture debate supports the idea that psychopaths are born rather than made, although environmental influences can influence how the disorder expresses itself. Describing how childhood psychopathic traits combine a range of antisocial behaviors with a callous, unemotional personality, lack of guilt and empathy, and resistance to socialization, he differentiates this cluster of characteristics from other problematic behaviors in children. In doing so, the author hopes to raise awareness of the condition in those most likely to encounter it, such as parents, teachers, and child therapists. Hare suggests that the absence of psychopathy as a listed childhood disorder in the DSM is evidence of the medical profession’s willful ignorance about the existence of psychopathy in children.
In exploring why childhood psychopathy has been overlooked, the author addresses the ethics involved in diagnosing children as young as preschool age. He implies that society’s idealized perception of young children as guileless and innocent creates a reluctance to recognize they can possess manipulative, predatory, and even violent traits. He also acknowledges the delicate ethics of attaching a label with “pejorative” connotations to children. While agreeing that “it is no light matter to apply psychological labels to children—or to adults” (160), he argues that society must overcome its reluctance to acknowledge the existence of psychopathic traits in children. Accurate diagnosis determines the appropriate treatment, and early intervention is crucial. Hare asserts that the current practice of treating the individual behaviors of psychopathic children rather than the overall condition is a waste of time and resources. Hare also points out that distressed parents are sometimes unfairly presented as the cause of their child’s problems, particularly by therapists who favor attachment theories to explain mental disorders. The author admits that effective treatment is challenging as psychopathic traits cannot be cured. However, it may be possible to modify their least desirable behaviors. Hare emphasizes the danger undiagnosed psychopathic children pose to society by selecting deliberately disturbing examples: the four-year-old who killed her twin brothers and “adorable, terrifying Tess” (170). Both stories emphasize the early manifestation of violent psychopathic traits.
Chapter 11 continues to emphasize the importance of correctly diagnosing psychopathy. The danger of psychopaths going undetected in the criminal justice system is illustrated by the example of Carl Wayne Buntion, whose release on parole led to the death of a police officer. However, Hare argues there is an equal danger of misdiagnosing or over-diagnosing psychopathy. In his anecdote about CBS and Saddam Hussein, the author highlights the media’s tendency toward casually diagnosing mental disorders in prominent figures based purely on their actions and behavior. The author suggests that “psychopath” is becoming a throwaway term rather than a serious medical diagnosis. The serious ramifications of “armchair” or “long-distance” diagnosing are illustrated in Dr. Jerrold Post’s incorrect prediction of Saddam Hussein’s wartime actions. The book emphasizes the unprofessional nature of diagnosing without a thorough clinical assessment of the subject. Hare also emphasizes that while the Psychopathy Checklist is a valuable diagnostic tool, it must only be those clinicians trained in its application.
In Chapter 12, the author returns to the continued challenges of treating psychopathy. Hare explains that the intractable nature of the psychopathy personality lies at the heart of the failure to find effective treatment programs. Not only are the character traits of psychopaths impossible to modify, but they lack the motivation to change. Consequently, Hare argues that treatment must focus on changing behaviors, and psychopathic patients must be persuaded it is in their best interests to do so. The author offers a glimmer of hope for the future by describing the treatment plan he has developed in Canadian prisons. However, his tone is one of limited optimism as he acknowledges that no solution has yet been devised for the many subcriminals who remain unidentified and untreated. In view of the currently limited scope of treatment, the author suggests that an awareness of psychopathic traits is the best form of defense against becoming the victim of a psychopath. Hare highlights red flags in personal and professional relationships that may help to identify them. However, he bleakly acknowledges that advice on “damage limitation” is the best he can offer to the parents and spouses of psychopaths.
The book concludes with a call to action, warning of a “social crisis” if society does not wake up and acknowledge the devasting impact of psychopathy. Introducing the concept of a “camouflage society,” the author suggests that rather than addressing the problem of psychopaths, aspects of contemporary society, such as gang culture, provide an environment where psychopaths can blend in and thrive. Furthermore, he argues that psychopathy is an under-researched condition compared to other mental disorders. The author emphasizes the need for a significant investment in research that reflects the scale of the problem and the threat that psychopaths pose to society. Hare highlights the inadequacy of current methods, comparing them to “applying Band-Aids” to a “life-threatening disease” (163).
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