A Commentary on The Response Aroused by the Psychopath and a Tribute to its Author, Neville Symington
Keogh, Tim
*This paper is based on Keogh, T. (2019.) A Commentary on Neville Symington's Paper “The Response Aroused by the Psychopath”. The International Journal of Forensic Psychotherapy 1:67-73 and is published with the permission of that journal and its publisher Phoenix Publishing House: Firing the Mind.
It is a privilege to have been asked to participate in this 2022 Neville Symington Conference which is really a tribute to Neville’s contribution to psychoanalysis.
Neville was of course well known internationally for his writings and was acknowledged by the IPA for his contribution to psychoanalysis by making him a recipient of the prestigious Sigourney Award. One of Neville’s lesser-known contributions was his writing in the area of forensic psychoanalysis.
In 2019 I was invited to contribute a commentary as part of the inaugural issue of The International Journal of Forensic Psychotherapy on Neville’s classic paper The Response Aroused by the Psychopath published in The International Review of Psychoanalysis in 1980.
Today I want to share something of this paper with you and with the help of my colleagues, explore the ideas he presents in this classic article.
I am comfortably aligned to Symington’s implicit view that forensic psychoanalysis offers a richness of understanding and an associated coherent approach to treating forensic patients that is lacking in mainstream psychological and psychiatric approaches. These mainstream approaches, whose focus is on the behavioural dimensions of the psychopathology underpinning their offending, often see the psychopathic offender as largely beyond help or helped only by altering his conscious thoughts.
In his article about the responses aroused by the psychopath Symington used Heathcliff, a central character in Emily Bronte’s novel Wuthering Heights, to introduce us to his view of the internal world of the psychopath. The novel describes the lives of two families of the landed gentry living on the West Yorkshire moors, the Earnshaws and the Lintons, and their turbulent relationships with the Earnshaw’s foster son, Heathcliff. Heathcliff is a good choice as he is not the typical romantic hero, one who may be initially brooding and cold, only later to be revealed as a kind and sensitive soul. Instead, he is an arch villain revealed to be increasingly malevolent. Another character, Earnshaw (who is the father of the house) is described as having a dream early in the novel; the dream is of a frightening ghostly figure attempting to enter the family house. This is a poignant dream given the character of Heathcliff was written about at a time (1840s England) of wretched poverty in industrial towns such as Liverpool, where Earnshaw found him. The conditions in these towns were like a living hell. The privileged classes feared some horrible revolt and revenge from this group that Heathcliff can be seen to represent. Whatever her intention in weaving this theme into her novel, Bronte nonetheless appears, as Symington notes, to be more focussed on exploring a type of individual character that was equally threatening and for whom revenge was a central driver. Symington refers to this revenge motive of Heathcliff to explain the seemingly paradoxical idea that the problems of the psychopath were attributable to emotional conflicts, in particular those regarding his primary maternal attachment object / mother. Moreover, he suggests how such an understanding can help us make sense of our responses to such patients and how this can lead to a fruitful analysis of their potentially catastrophic difficulties.
Symington draws on the psychoanalytic understandings of Freud (1917), Klein (1934), Glover (1960), and Hyatt-Williams (1998) which highlighted how seductive it can be to regard manifestations of psychopathy as indications of a lack of humanity, rather than an obfuscation of need for relationship, resulting from overwhelming psychic pain at a time when the psychic apparatus was insufficient to process it. He suggests that the psychopathic individual has undergone “an experience of sadness so intense that it is not experienced consciously but is dispersed through the personality in the form of ruthlessness and despair”. He further adds that this happens at a stage of psychic development characterised by a lack of separation and individuation from his (primary maternal) object. Moreover, he argues that so much of the psychopath’s motivations can be accurately predicted using this vertex of understanding, in particular his need to deal with murderous revengeful rage towards his primary object, who is maddeningly indistinguishable from himself, as illustrated by Heathcliff’s relationship with another character in the novel, Catherine.
Symington further suggests such an understanding can help us to appreciate particular responses to the psychopath, namely, our potential collusion with him, our resort to disbelief about his actions, or alternatively our condemnation of him. These responses can be seen to result from the very primitive psychic mechanisms employed by the psychopath, notably projective identification. He further notes that being psychically provoked in this way can lead to defensive manoeuvres which can not only lead to moralising about and politicising psychopathy (so common in the criminal justice system), but can seriously disable our attempts to understand and help such patients.
His views in this regard are similar to those of Hyatt-Williams (1998), who wrote about the "death constellation" and the imbalance of the destructive and constructive elements in the personality that co-occur with a combination of constitutional and environmental issues. In explicating this constellation, he suggested that when this imbalance coalesces into a character trait, the person has to kill off whatever is too painful. Moreover, Hyatt-Williams argued that it is possible to establish a relationship in which mourning and remorse can become possible in order to help such a patient find his more human potential. As such he stressed that mourning, whilst an essential ingredient for mental health in general, is especially important in psychically processing the murderousness that arises from the death constellation.
The notion of the psychopath as an individual characterised by an absence of any apparent emotional response can be traced back to Philippe Pinel (1801), who had first suggested that there was a group of patients suffering with what he termed manie sans délire [insanity without delirium] (Pinel, 1801).
Recent work on the neurophysiological underpinnings of different types of violence also points to this apparent ablation of an affective response in the psychopath. Meloy (2001) has pointed out that the neurophysiology underpinning so called sadistic violence, compared to the predatory violence found in psychopaths, is quite different. His categorisation of violence is similar to that described by Glaser (1998) who, in articulating the Core Complex that underpins violence (a complex linked to the desire for merger with the maternal object), suggests that it can be seen as a continuum that encompasses, at one end, a self-preservative violence, where violence is seen to be in response to threats to the sense of self, to sado-masochistic violence, which appears random and detached from any such threat. Such predatory or sado-masochistic violence, that seems hard to comprehend, results in acts of violence that Alvarez (1995) has referred to as representing “motiveless malignity”.
With all of this in mind I feel that there is also great heuristic value to be mined from considering developments in theories about psychopathy that have developed since the time when Symington first authored his paper. For me this includes theoretical ideas that focus on the role that severe pathological narcissism plays in the dynamics and phenomenology of psychopathy and the unique nature of the primitive object relations found to be linked with it.
For example, I believe a consideration of the role of forms of severe pathological narcissism in particular leads to a unique and helpful understanding of one’s response to and experience of (or ultimately countertransference related to) being in the presence of the psychopath, especially the experience of being objectified and duped by him. This is an essential phase of the relationship that needs to be analysed and is the precursor to a paranoid transference to which it gives way. It must be courageously endured and interpreted in order to achieve a fruitful analytic process.
In this regard Kernberg (2004) highlighted that psychopathy represents the most extreme of all narcissistic pathologies, regarding it as a more serious pathology than malignant narcissism, which Fromm (1964) had described as “the most severe pathology and the root of the most vicious destructiveness and inhumanity” (p.33). Meloy (2001) also subscribes to the view concerning of a basic failure of internalisation (of a good object) accompanied by a severe narcissistic psychopathology, primitive internalised object relations and superego abnormalities.
In such a developmental context I see the self as having experienced trauma and rejection by its object, which result in an implicit turning away from the object (involving massive splitting and projection). Those present at the Conference last evening will recall this is something that Neville highlighted in his view of Narcissism in the documentary that we viewed together. This turning away from the object often results from the psychopath’s abusive experiences with their object and leads to an over-investment in a relationship with oneself. This becomes so exclusive that others are not just responded to as self-objects, but objects that are manipulated and ruthlessly used by the self as he becomes more intoxicated by his own omnipotence and grandiosity.
Contemporary psychoanalytic theorists, in line with trends in neuro-psychoanalysis, have also attempted to integrate psychoanalysis with relevant findings from other disciplines. Meloy (2001) for example, influenced by attachment theory, suggested “the house of psychopathy is built on a psychobiological foundation of no attachment, under-arousal and minimal anxiety” (p. 3). I feel this description provides a useful therapeutic compass and a functional view of the psychic topography of the psychopath which can help the analyst/therapist understand his defensive bastion and again, the “conning” or “duping” transference relationship that he develops with others.
A further important contribution to our understanding of psychopathy I feel has been the elucidation of the concept of the stranger self-object introduced by Grotstein (1982) and elaborated by Meloy (1997). Meloy argued that the process of internalisation of this stranger self-object has involved a precocious separation from his primary object that occurs during the symbiotic phase of maturation. He suggests that this helps us to understand how the psychopath needs to relate to the analyst and reveals his developmental failures. These include, as Hyatt-Williams (1998) has pointed out, basic failures of maternal containment.
In this regard Meloy (1997) notes:
Failures of internalisation that begin with an organismic distrust of their sensory-perceptual environment; a predominate archetypal identification with the stranger self-object that is central to the conceptual self and object fusions within the grandiose self-structure … (and that what results is) … a primary narcissistic state of attachment to the grandiose self and sates of relatedness that are aggressively and sado-masochistically pursued with actual objects. (p. 59)
To consider the value of Neville’s original ideas and these subsequent theoretical and empirical contributions I now want to refer to a brief clinical vignette of my work with an offender who, following a number of other violent and other non-violet offences, had been charged with a murder in which the victim’s throat was cut. In the first phase of the work my patient regarded me as very helpful to him, providing him with a number of benefits that other inmates did not enjoy. He would tell me what he thought I needed to hear. He would also convince me of the benefits of ways we could both get around the system, in particular that he would be more able to believe that I wanted to help him if I could arrange favours for him such as getting him cigarettes.
My counter-transference was that of consistently feeling I was being used for his purposes. Interestingly, he lacked any insight about the fact that I could see what was going on. I was later able to find a way of talking to him about his experiences with his very brutal father who, amongst other abuses, had burnt him with cigarettes as an infant. I noticed he was very protective of his mother, despite the fact that it seemed she had been complicit with the father and subsequent abusive partners she had. He mentioned that he did remember having fleeting thoughts, during moments of cruelty he endured with both of them, about cutting their throats. After discussing this issue in a session, he attacked another inmate with a toothbrush that had been made into a dagger. He was consequently placed in a more restricted unit as staff began to speculate that seeing me was a waste of time.
Interestingly, he felt that I had some involvement in the decision to have him moved to the much more restrictive and for that matter more dangerous unit and that, perhaps like his mother, I had been complicit in what he perceived to be his being abused. He did, however, agree to see me, but the feeling had changed between us. I felt that there was a much more conspicuous anger towards me. The transference had changed; he had previously felt that I had been someone he could dupe and therefore regard positively (as long as I behaved in accordance with his internal script). I wondered aloud if he thought I had been involved in the decision and whether he might have felt burned by me. At this moment I felt cold and had the experience of the hairs on my neck standing up. I had a sense of blind fear.
In response to this I acknowledged that he felt angry with me, but in talking about what had happened on the unit I also said to him, “I think we both know that you also felt very hurt and angry as a child and that someone needed to pay”. His response was intense. It was a difficult moment. It felt touch and go. He responded eventually with a death stare saying, “I will kill you if you tell anyone about this”. I noted that it felt very dangerous to acknowledge these things. At this moment I was struck with the horror of what he was capable of and felt the full force of murderous rage.
It was an awful experience, but surviving it together meant we could move forward.
I feel that in addition to understanding my response to his psychopathic behaviour and working with the associated transference it helped me to understand what Symington had pointed out, that I needed not only to understand the pressure to collude with him, but to also deal with my own disbelief and feelings of condemnation. This was so that I could better understand more about his hatred of the object and his need to turn to himself in such an extreme way. I needed to allow myself to feel this set of somewhat alien emotional experiences in order to move into a more transformative zone with him.
This required me to allow my countertransference to him to spawn images that could facilitate the emergence of metaphors that we could utilise as starting points for the development of more adequate symbolic functioning. This needed to be contained in a relationship that solid enough to facilitate the integration of his murderous rage and the associated guilt he would have to bear, without the need to resort to suicide.
Clinical challenges
In the clinical situation one often finds that typically there is a sequence of events that unfold in an analytic process with such patients. Key amongst these is an initial therapeutic relationship wherein the patient wishes to gain omnipotent control over the analyst by clever and seductive means that often involve duping or “conning” him. When one experiences a countertransference that is consistently of feeling one is being used, the patients may often lack the insight that the analyst may see though this. This illustrates the problem that the psychopath has in understanding the states of mind of the other and therefore being relatively incapable of empathy until this is addressed.
In cases where the relationship develops and this modus operandi is broken down the relationship can collapse into a more paranoid relationship where the analyst can be seen to be very threatening. At this point with some patients the analyst can be in some danger.
In working with such patients, in addition to understanding one’s responses aroused by psychopathic behaviour and working with the associated transference, one also needs to closely understand the abovementioned pressure to collude with the patient as well as at times to deal with one’s own disbelief and feelings of condemnation. One ultimately needs to understand something about patient’s hatred of the object and his need to turn to himself instead, in an extreme way. As I have said I believe that one needs to allow oneself to feel emotional experiences in order to move into a more transformative zone with such a patient.
All of this work needs to be contained in a relationship that is solid enough to facilitate the integration of the patient’s murderous rage and the associated guilt he would have to bear, so as he does not need to resort to suicide.
Conclusions
The experiences I have attempted to articulate in the therapeutic relationship with the psychopath also link to Alvarez’s (1995) reflection on Symington’s trio of responses to the psychopath. She notes that “in order to avoid this trio of collusion, denial and condemnation, it is important, firstly, to avoid the last…and…instead of condemnation, it is necessary to look evil straight in the eye”. This implies not evading the full bleakness and horror of the patient's impulses, nor the inadequacy and foolishness of their internal objects and of ourselves in the transference”. (p.181)
In concluding my brief consideration of clinical issues with psychopathic patients I would now like to return to Neville Symington and say, as Carine Minne noted, that this paper is really a forensic gem and leaves forensic psychoanalysts with a lasting legacy. In this regard I also look forward to hearing our discussants’ views.
Finally, though, I want to say that the Australian Psychoanalytical Society is rightly proud to have had a member who has made a rich contribution to forensic psychoanalysis. I hope that Neville’s forensic contribution will be kept alive in Australia by those of us who have established the new Australian Forensic Psychotherapy Association (AFPA) and internationally by analysts working with forensic patients.
Ultimately, Neville’s legacy is contributing profound understanding and humanity.
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