Rob Kall: So, you know - I have to say, I've got a list of questions here. Well, let me hold back. How does this disorder relate to evil?
Donald Black: That's an interesting question, and I do address that in the book. I basically sidestep the issue by saying, "Evil is a philosophical or religious concept that, in my view, has no place in medicine or Psychiatry." Certainly people commit acts that you or I might call evil. For example: Osama bin Laden and the Twin Tower disaster of 2001. That was an evil act. I think most people would say that is the probably about the most evil thing someone could do, and then we saw him on videotape laughing about it. Thousands of people dead, and then he's laughing about it. I characterize that as evil. Or, think of a serial killer like Ted Bundy or John Wayne Gacy, who was torturing or murdering someone essentially for his own twisted pleasure. That to me is evil. However, as a psychiatrist, I don't use that term in my daily practice, and I wouldn't encourage my trainees to use it either, because it has religious and/or philosophical connotations that I don't think are appropriate for mental health professionals to be discussing.
Rob Kall: That's fair enough in terms of talking about Psychiatry; but you're an expert on sociopathy, so I'm kind of asking you also from the perspective of culture, and the perspective of how evil is conceptualized. It just seems to me that evil is perpetrated by sociopaths.
Donald Black: Well, a lot of it is, but then you could argue that Osama bin Laden does not meet the definition of a sociopath, because he doesn't have all of the cardinal symptoms that we would expect for that disorder, including a history of childhood misconduct. So even non- anti-social people can commit evil acts. Now, I do make the argument in my book that Saddam Hussein probably was a sociopath and would have met our definition. We have specific criteria that we use to make the diagnosis, because he has a documented history of misbehavior going back to early childhood, and continuing until the time that he was (essentially) caught and incarcerated.
Rob Kall: Another
thing you say in your book is, "They rebel against every type of regulation and
expectation, seemingly oblivious to the value of living within societies
boundaries. Despite all sanctions,
parental punishment, ostracism, failure, or jail, they remain stuck in a rut of
Donald Black: Yes, absolutely. They don't like rules, they don't like regulations, and they don't seem to learn from the bad consequences of their behavior. They are stuck in that rut that they can't seem to get out of. Now, as some of them get older they do seem to climb out of that rut, because anti-social behavior in general tends to subside as people get older. It's unclear why. Maybe they're more mature, maybe they're just too tired to act out, who knows; but they do tend to improve over time.
Rob Kall: Now, that description, somebody "resisting regulations and expectations," it can also apply to protestors, dissidents. And in other countries, sometimes dissidents have been jailed under psychiatric pretexts.
Donald Black: Yeah.
Rob Kall: How do you reconcile that idea, that people who protest, people who engage in civil disobedience and get themselves arrested are -- how do you separate the protestors from the sociopaths?