What are Sociopathy and Cleckley's List?

Now Termed Antisocial Personality Disorder, Once Was Moral Insanity

Jul 23, 2009

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Cleckley was the pioneer in developing a list of sociopathic characteristics in accordance with thought in the mid 1900s. There's no one sure treatment for the disorder.

Sociopathy varies in degrees. The number of diagnosed sociopaths in psychiatric institutions is relatively small. Many are incarcerated, but more live in society. They might be con artists, imposters, tricksters, charlatans or unscrupulous professional or business people. They can be politicians, lawyers, psychiatrists, psychologists and doctors.

Some mental health professionals use the terms Antisocial Personality Disorder or APD, psychopathy and sociopathy interchangeably although some others theorize that sociopathy is a type of psychopathy.

Early Recognition of Sociopathy

During the nineteenth century, morality was related to personality. In 1835, English psychiatrist James Pritchard coined the term moral insanity for criminals who had no self control and nor sense of ethics. These individuals were believed to have normal intellectual capabilities, but their behavior was improper and indecent.

Years later, the idea of psychopathic inferiority was developed. The prevailing assumption was that the nervous system was defective. In the early part of the twentieth century, the American Psychiatric Association defined what constituted a psychopath. They were amoral, antisocial, impulsive and irresponsible, satisfying their egocentric needs with without concern for consequences and had little guilt or anxiety.

A distinction between a sociopath and psychopath was formulated. Sociopaths were thought to act within the law; psychopaths violated the law. One mental health professional said these people’s behavior was acceptable to no one but themselves.

Mental health professionals noted that typical sociopaths were very charming. They speak well, are ingratiating and talk of their experiences. These experiences are often are often exaggerated and/or lies. They are often pathological liars. Their descriptions of events are generally different from others’ recollections.

Hervey Cleckley’s List

In 1955, Cleckley published a list of core characteristics of the sociopathic personality in his book, Mask of Insanity. He had sixteen personality traits:

Superficial charm and intelligence
No delusions
No psychoneurotic behavior
Unreliable
Pathological lying
No remorse
Insufficient motivated antisocial behavior
Poor judgment and doesn’t learn from experience
Cannot love
Poor in primary experience in feelings and emotions
Loss of insight
Not responsive in over all interpersonal reactions
Obnoxious behavior when drunk and, at times, when sober
Suicide threats rarely attempted
Sex lives impersonal
Fails to follow a plan of life

Treatment for Sociopathy

Sociopathy is treated in different ways, but there is no known cure and the effectiveness of the treatments is not clear and a matter of controversy. Psychopathy can co-exist with other psychiatric disorders.

The primary challenge in treating APD is that the patients usually don’t believe they have a problem. The behavior is often magnetic and charming. They also believe their behavior works and is satisfying to them.

Treatment for sociopathy is individualized and there is no one approach. Many sociopaths have a sense of superiority and think they’re smarter than mental health professionals. Many with are in treatment because they are pressured by family members or mandated by court order. Sociopaths can mimic acceptable behavior and manipulate doctors and therapists.

Different psychological therapies are available. These can be used in conjunction with psychotropic drugs and physical therapy which consists of electroconvulsive therapy, ECT, better known as shock therapy and neurosurgery, the least used and most radical.

Some sociopaths become disenchanted with their behavior and spontaneously grow out of the disorder.