Deadlocks and Dangers of the Diagnosis of Psychopathy

This paper argues that the diagnosis of psychopathy, promoted by the author of the PCL-R Robert Hare, contains many implicit assumptions. It is not the logic pertaining to the decipherment of the subject’s urge to a criminal act that is central within this account, but a calculation of danger and the nomination of evil. Hence, in our opinion scientific research that is rooted in the work of Robert Hare should always question these implicit assumptions. Therefore the author offers a close reading of Hare’s work, in which he discerns a political factor in its incessant attempt to reduce the anxiety related to the Other. In contrast with Hare, an important aspect of Freud and Lacan is highlighted concerning the issues of crime and guilt. Finally, recent attempts to recuperate the concept of psychopathy in psychoanalytic theory are criticized.

How ‘normal’ is ‘pathological’? Psychiatry and clinical psychology as a new means of disciplining.

This contribution originates with a number of problems in the current psychodiagnostic and therapeutic field which give rise to important ethical, clinical and scientific questions: questions that, from a broader social perspective, are interrelated. The criteria for psychopathology depend on socially decided norms and values (ethics), which coincide with the societal context. Current neoliberal discourse dictates a medical model that determines the manner in which scientific research is conducted, resulting in so-called evidence-based DSM-based diagnostics. In the clinic, this psychiatric handbook is used to identify individuals that deviate from the proposed criteria, with the goal of treatment to ‘normalise’ them. This is little more than a form of social standardization and patients are becoming increasingly aware of this. However, what little protest has occurred has had correspondingly little impact. Psychotherapy is hence at a tipping point. To protect our discipline, it is necessary to explicitly see the sea in which we all swim and to question our own role in determining the general perspective.

Conversations with Howard Shevrin II, Ann Arbor, June 17th, 2005

According to Howard Shevrin, psychoanalysis is first and foremost due to Freud’s creation of a new method: the patients have to say anything that comes into their minds. For the first time, it became possible to be in touch with the full extent of human experience. The two fundamental pillars of psychoanalysis are (1) the dynamic unconscious and (2) the primary process nature of that psychological unconscious. The psychoanalytic method is based on assumptions for which the evidence can only be provided from a more basic science. Psychoanalysis is over rich in theory, while psychology has empirical generalizations but no real overarching theories. As a result, researchers in psychology come up with a lot of usually trivial findings, but these findings get lost, because there is no context in which they can remain, so the same things are discovered over and over again. While psychoanalysis as a treatment has come under attack, psychoanalysis as an understanding of the mind has been doing much better. However, unless that theory is presented in a coherent way and takes into account recent scientific developments, it will simply fall and its bones will be picked.