The Villian: myths and misconceptions

"One of the most troublesome and pervasive source of misperceptions in the area of the mystery and crime genre is the concept of the disturbed antagonist. Often terms such as psychotic, psychosis, schizophrenic, and psychopath/sociopath are misused and misunderstood. Many of these misunderstandings are deeply rooted in the common media and in fictional writings, leading to a misperception of what these terms mean and how they apply to the "evil" and "disturbed" characters that so often surface in the context of the villain. So what do these terms really mean, and how are they used or misused in the genre?

In this article I will describe these terms as well as address the aforementioned questions with the assistance of personal experience and case studies. I have worked in many hospital and mental health facilities, including forensic settings. I have interviewed several hundred people with schizophrenia for over seven years as well as other mentally ill populations.

So who, then, is a psychopath? This term is often used to describe the unfeeling, manipulative, yet charming and ingenious antagonist who wields the perfect foil for the hapless protagonist. This perception may very well be accurate in some cases, but is ubiquitously misused. Antisocial Personality Disorder, or APD, is often applied to these kinds of individuals. According to the Diagnostic and Statistical Manual of Mental disorders, APD is equated with sociopathy and psychopathy, implying that the two are one and the same. However, some researchers have proposed that the psychopath is not just simply APD, but there is a broader concept involved. This, unfortunately, has not been totally resolved, and there is still much debate in the area. Here I will discuss the two as essentially one and the same.

An APD-afflicted individual may well be very aggressive, manipulative and unfeeling, but the charming and uniquely literate individual that is often associated with these concepts is not a necessarily linked concept. Yes, Hannibal Lecter is a psychopath/sociopath, but he’s not the template. Most psychopaths are neither charming nor necessarily well educated or deliciously conniving individuals with extraordinary abilities simply lacking in empathy. I will discuss cases of APD as well as schizophrenia to distinguish the two and illustrate the differences in concepts such as insight and violence.

I recall one interview with a patient, Mr. A. , who was afflicted with APD. An unstructured interview was used to examine the manifestation of the illness. Mr. A. always seemed downcast, rarely made eye contact, and showed virtually no affect except the occasional scowl. During the interview, he began to describe “problems” he had been having with his tenants, mostly that they owed him money and were completely irresponsible. His answers were short and concrete. He described the people involved as “leeches” which he also generalized to most of the population. He was mistrustful of everyone. Halfway through the interview, Mr. A. walked out of the room in seeming disgust, no longer interested in what I had to say.

An oft-cited case of an APD individual is one who had let a small child play with a gun he owned. Tragically, the gun went off and the child was killed. When the police interviewed him, with a blank expression he described the events without any kind of reaction to the terrible tragedy. He wondered idly how it happened, but mostly said things like “she played with it. The trigger must have been pulled.” He remained calm and composed. This lack of affect, even in the face of such terrible circumstances, is often found in the APD individual.

Violence is indeed strongly linked to APD, but here are many factors involved in the creation of the psychopath or antisocial personality. Often factors in childhood and adolescence, including family adversity, perinatal complications, and rejecting parenting styles all contribute. However, this might lead one to a misleading conclusion that the abused child is doomed to a life of psychopathy or antisocial behavior. There are other mitigating factors such as genetic vulnerabilities and neurological dysfunction as well as environmental and biosocial contributions. So, yes – as much as films such as Red Dragon emphasize abuse as a strong mitigating factor, it is clear that most abuse survivors do not become psychopaths or antisocials.

There seem to be clear neurological syndromes associated with the psychopath and antisocial behavior. Tools such as structural and functional magnetic resonance imaging of the brain have shed a lot of light on this subject. Brain centers indicated include parts of the frontal cortex (often referred to as the seat of “executive functions”), the amygdala (involved in emotional reactions), and the corpus callosum (which relays information between the hemispheres of the brain).

Psychopaths are often said to have “insight deficits,” or poor societal perspective and poor understanding of what is right and wrong. This can be seen in the callousness of Mr.A. and the other case study described above. Words such as cruelty, callousness, and dishonesty have been used to conceptualize the syndrome. Psychopathy is often described a disorder of empathy, or an egocentrism and failure to assess and react to the feelings of others. Psychopaths lack the basis, it would seem, of moral understanding. As will be discussed, people with schizophrenia, who are often mistaken for psychopaths, have another kind of insight deficit, although the two sometimes overlap.

Other badly misused terms include the definition of the sociopath to be ‘psychotic.’ Psychosis is used in the context of a dissociation or disconnection from reality, a lack of insight into what is real and what is not. The psychotic symptom could be a delusion (a false belief that is strongly held) or a hallucination (a false perception that is strongly held), among other “thought disorders.” Individuals afflicted with psychosis are by no means necessarily disturbed masterminds or horribly twisted individuals.

Schizophrenia generally involves psychotic symptoms as well as cognitive deficits and is a very disabling disorder in which roughly one-third of inflicted individuals do not respond to medical treatment. People with schizophrenia generally perform worse on virtually any psychological assessment than non-afflicted individuals, including indices of IQ. This stands in stark contrast to the idea of the brilliant but disturbed individual who is by nature prone to violence and aggression. Although antisocial behaviors and violence can be associated with schizophrenia, the media often overstates this association, and the acts are mostly inked to substance abuse, noncompliance with treatment, and active psychotic symptoms. Victims of the disorder suffer most difficulty in living day-to-day lives, hardly the portrayed manipulative geniuses or aggressive psychopaths the media often associates them with. While many may suffer auditory or “command” hallucinations (i.e. voices telling them to perform certain acts), it is only a minority of these individuals who actually perpetuate violence, even though there is a stronger link between violence and schizophrenia versus violence in the non-afflicted population.

One schizophrenic individual I came in contact with while interviewing was a man who exhibited nearly all of the “textbook” symptoms of schizophrenia. He claimed that the radio and television had been talking to him for many years. As well, he described his environment as a blurry construction of objects which constantly switched appearance and he had many hallucinations of people that were long dead or characters from movies or television. While this individual was clearly very impaired, he seemed friendly and compliant and said that he was allowing the interview because he believed we were “doing God’s work,” although he was hesitant in admitting this belief.

One patient, Mr. B., suffered from command hallucinations. He described the experience as loud voices inside his head, asking him to perform certain acts, as well as hearing distant conversations and “messages from God.” However, Mr. B never engaged in violence and felt the idea was abhorrent. In fact, Mr. B described some of his auditory hallucinations in a positive light, hearing things like “You’re doing well.” I have found that a vast majority of people with schizophrenia are religious, and many attribute their ‘abilities’ to a higher power. The majority of patients who are under proper treatment often have delusions that, while disorganized and detached, that they must help mankind, or have an ability to help mankind. An example is Mr. C.

Mr. C was an inpatient at one of the psychiatric wards. He had a classic textbook symptom often referred to as word salad; he produced words that made no sense and seemingly created without a purpose. He constantly referred to something called “the Pababa,” although he never defined it. One of his delusions was that maple syrup and bubble gum caused schizophrenia, and his job was to warn people of this fact. He felt he was truly entrusted with this mission, and although he did not attribute this moral imperative to religious roots, still felt that he needed to help people. Religion or not, it does seem that many schizophrenic individuals do believe that they can and/or must help people. Another patient, Ms. D, felt she was going to save the world at age 100 by being sawn in half. While these beliefs would seem to an unafflicted individual bizarre and perhaps misguided, most schizophrenic individuals lack insight into their illness and consider these beliefs to be completely accurate.

While people may acquaint these psychotic symptoms and APD-like symptoms because they both involve lack of insight, the two are quite different. Often people with schizophrenia have poor insight with relation to their disorders; I have seen many cases in which patients had other explanations for their presence in a hospital or in treatment. Mr. E., explained that he was fully mentally functional, and despite obvious symptoms such as belief in extraordinary abilities such as ESP and mind control, explained away his presence in the hospital as treatment for headaches. There was no evidence that a staff member had given him this perception; he seemed to accept the fact that he was in a long-term facility but failed to acknowledge any illness.

In contrast, another patient, Mr. F., seemed happy and optimistic and did have insight into his disorder; when asked why he was in a facility he simply said “I have schizophrenia,” an uncommon admission especially in more ill patients. He also responded cogently to questions about hospitalization and his medication, claiming that he did need to be in the hospital due to the schizophrenic illness, and that he needed to take medication because it helped abate his symptoms. He was very upbeat and exhibited realistic thoughts that he was gifted in areas such as playing the piano and a talent for mathematics (he did have an advanced degree). Thus, levels of insight in these illnesses is often on a continuum. Most patients attribute their medication to “sleeping problems” or headaches, but they remain compliant with treatment even though they may feel that their treatment is not benign.

Mr. G. was a compliant, friendly individual who was pleased with the interview and the memory tasks given, often fascinated by them and had the desire to know about their roots. He claimed that he was doing the study because it “may help people like me.” In contrast to this seemingly realistic and benign outlook, he constantly complained that he was being poisoned by the staff through his medication. Despite this, he remained friendly and accepted treatment without complaint. I often met Mr. G. in the halls of the hospital, and after greeting me warmly, he often said variations of “Hi James! They’re trying to poison me again.”

Having worked in forensic psychiatric wards, I have also come in contact with people with schizophrenia who have committed crimes. Usually in these cases the patient is actively psychotic and often do not know what right or wrong are.

Mr. H., for example, while in a severe phase of his illness, had an altercation with the police in which he obtained a policeman’s gun and shot and killed him. As a result, he served a relatively long stay in prison, but when he was treated with antipsychotic medication, he became very remorseful of his actions, was almost completely asymptomatic, and was one of the most kind and considerate individuals I’ve met, ill or otherwise. When approached with the idea of participation in my study, he happily accepted also citing as his reason that these investigations could prove to be helpful to others in his situation. He was highly regarded by the staff and accepted responsibility for his actions, despite the fact that he was clearly very unwell when he committed them.

This transformation after treatment is often seen in schizophrenic individuals in forensic psychiatric wards. Once they have been treated, they often agree that they were very unwell during this activity (with the consensus of staff) and believed that they needed treatment and would be compliant, sometimes in situations where they knew they had to spend years in various psychiatric wards, locked or otherwise.

Another common idea is the idea that all psychopaths, or many of them, have suffered neurological damage or have lived lives of constant abuse. Does a traumatic childhood lead to an individual becoming a psychopath? Perhaps. However, if one considers the amount of abuse survivors who do not become horribly dysfunctional individuals, one would probably come to the conclusion that abuse does not necessarily lead to a life of aggression or psychopathy. While neurological problems or early trauma may indeed lead to aggression, when one considers the population as a whole, there may be an equal or even greater amount of people that instead lead lives characterized by suffering and debilitating illness.

These problems in the conceptualization of the villain and his or her roots, then, are serious ones. When one turns to the factors mentioned to build the “evil” antagonist, it is therefore very important for writers and readers to understand that the template for the villain is much more complex – and this should be reflected in more thoughtful writing and reading of the crime and mystery genres. After all, if you were an abuse survivor, would you like to be characterized as a person doomed to become a deranged, antisocial psychopath? Let’s think twice about what we write about and the impact it may have on those people who are the readers. Much like the media puts a magnifying glass on the actions of a small proportion of the mentally ill, so is this reflected often in common misperceptions. Writers and readers need to be more informed and avoid propagating these damaging stigmas that are so difficult to overcome."

by James I. Wasserman