Are “Psycho Killers” Psychotic?

Charles Manson mugshot

California Department of Corrections and Rehabilitation [Public domain]

They may not be politically correct, but the terms psycho killers and psychotic killers get tossed around rather freely.  Sometimes people will assume that to do horrific things people must be psychotic.  But is that accurate?

The notion that behaviours that make no sense must come from psychosis may originate from a few different mistaken assumptions.

Psychosis

One is confusion about the word psychosis and what exactly that means.  Psychosis is a cluster of psychiatric symptoms including delusions, hallucinations, and/or highly disorganized thinking.  Psychosis impairs the ability to distinguish between what is real and what is not.  It can occur in the context of a number of different psychiatric illnesses, and may also be drug-induced.  Regardless of the cause, the definition of psychotic symptoms remains the same.

Another mistaken assumption is that people would not be able to commit heinous acts if they were in touch with reality, so therefore they must be psychotic and disconnected from reality.  However, human beings have been doing very bad things to each other for a very, very long time.  Even if mental illness did make people perpetrate violent acts (which is rare), it seems wildly unlikely that psychosis spread like wildfire through, say, the SS guards in Nazi concentration camps.

Psychopathy

So, if killing in cold blood while fully aware of one’s actions is something that can happen, what on earth is going wrong in the minds of people who perpetrate some of the most atrocious crimes, like serial killers?

One possible answer is psychopathy.  It’s not a disorder in the DSM-5; the closest equivalent would be antisocial personality disorder, but taken to a more extreme level.  Psychopaths lack empathy and tend to be extremely skillful at manipulating the people and situations around them to serve their own needs.  They have a strong need for control and a lack of remorse for the negative effects of their actions on others.  While the words themselves sound similar, being psychotic and psychopathic are two extremely different things.  Psychopaths are very much in contact with reality and are in control of their actions.

The causes of psychopathy are complex and poorly understood, but this isn’t something that develops spontaneously later in life.  Psychopathic individuals begin to demonstrate problems in childhood.  Childhood bullying and abuse by family members are common in this population.  They tend to demonstrate elements of what’s known as the Macdonald triad for predicting future violence risk: arson, cruelty to animals, and bed-wetting beyond age 12.

Characteristics of serial killers

Serial killers often have intense fantasy lives.  We all fantasize to some extent, but we’re able to maintain a clear distinction between our inner world and the world around us.  As children, serial killers tend not to have learned to establish these boundaries, so violent fantasies spill over into real-world behaviour.

Many of the prominent serial killers people are aware of, like Ted Bundy and John Wayne Gacy, were very deliberate and methodical, which required them to know exactly what they were doing.  They are considered “organized” serial killers.  They are very much in control, and none of this is consistent with a psychotic thought process.

“Disorganized” serial killers, on the other hand, tend to be more impulsive and erratic, and they don’t usually try to hide the bodies.  Mental illness may be part of the picture with this subtype.

Cult leaders

Cult leaders responsible for mass suicides or other violence (e.g. Jim Jones, David Koresh, Charles Manson) are another type of perpetrator that may fall under the idea of makes no sense, therefore must be psychotic.  However, consider the level of finely tuned manipulation that would be required to exert total control over a group of followers.

Someone who was psychotic would never be on the ball enough to wage that kind of psychological campaign even if they wanted to. While the type of individuals that would engage in this type of manipulation are deeply disturbed, that does not make them psychotic.

 

For all the books and tv shows that try to get inside the heads of these criminals, the reality is we’re never going to get a clear picture.  There is no clear “why”.  What is clear, though, is we should not be assuming that serious mental illness is responsible for people doing the unimaginable.

 

Source: Wikipedia: Serial killers

 

book cover: Making Sense of Psychiatric Diagnosis by Ashley L Peterson

 

My book Making Sense of Psychiatric Diagnosis breaks down the different categories of DSM-5 diagnoses, explaining the diagnostic criteria and providing first-hand stories of the various illnesses.  It’s available on the MH@H Store, as well as Amazon and other major retailers.

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31 thoughts on “Are “Psycho Killers” Psychotic?

  1. BeckiesMentalMess.wordpress.com says:

    Extremely frightening. I watch so many of those true crime shows, and the ones on Netflix, and I’m always astonished of the things that happen to the deviant as a child. It’s scary that no one picks up on this behaior earlier on in years.

  2. Meg says:

    Great blog post, and in perfect time for Halloween! Scary!

    Yeah, I definitely wish people could quit confusing psychotic with psychopathic. And, while they’re at it, with psychic. Like, “Hey, I accurately guessed the future! I must be psychotic.” [Facepalm.] I’m not sure why, but that was a running joke when I was a kid.

    Reading this blog post brought to mind images of psychopathic people I’ve encountered. The level of manipulation and charm is scary! 😮 I was on a forum once for mental illness, and I was chased away by the converging psychopaths. They were supposed to stay in their own little forum, but being psychopaths, they couldn’t help themselves. [Shakes head and rolls eyes.]

  3. Luftmentsch says:

    Yes. I think it scares people that we don’t understand why people could commit brutal crimes with no obvious financial, religious or political motive. We feel there should be some cut-off in the brain that would stop people doing that, and it must somehow get by-passed for a serial killer. The superhero genre doesn’t help. I like Batman, but I get annoyed that all the villains are supposed to be murderously “insane” yet capable of plotting complex crimes and escapes.

  4. kachaiweb says:

    This is really good content, to the point and very clear. Research is being done on brains of serial killers and psychopaths so there is a possibility of understanding more. A relevant distinction can also be made between the psychopath and the perverted. I took a class on that in uni and while writing my paper on it, I discovered places on the internet that I’m still processing as so to speak. People always are shocked that I know these things but we all need to learn no?

    • ashleyleia says:

      Yes we do. It’s astonishing (not necessarily in a good way) what the mind is capable of. And hopefully the better these kinds of things are understood the more that can be done early on to change the trajectory.

  5. Melanie B Cee says:

    Aren’t sociopaths also in the category of person who may be(come) a serial killer? Or is that another under the umbrella of antisocial behavior personality? I personally think media (movies and docudramas and so forth) have glorified serial killing, so people with tendencies that way might be motivated because it ‘looks cool’. I’m horrified with the casual nature that murder and mayhem is dealt with in the media, and how films like “Split” (which is a horrible film) are viewed as really cool how ‘he’ (the villain) gets away with so much. That film made me sick.

    • ashleyleia says:

      Sociopath is a non-clinical term that overlaps antisocial personality disorder and psychopathy. I agree, the glorification of these assorted sick and twisted things is really problematic.

  6. Michelle says:

    When I have read about why people do mass shootings, I always read they were mentally ill or something along those lines. It seems like people need a reason as to why they would kill or try to soften what they did.

  7. Joshua Shea says:

    Whenever my wife sees one of these people on TV doing something horrible to a child or shooting up a school or whatever, she always comes from the point of view of how can somebody do that and I always say that it is somebody who is not wired correctly. Even contract killers have some kind of wiring off despite their “doing it for the money.” I’ve always believed that, for instance, with school shootings, that it is possible to plan everything, create a sound strategy for attack, yet still be completely insane. Premeditation should not be the litmus test for sanity. My very first therapist told me for six or seven weeks I wasn’t mentally ill when I knew something was wrong that wasn’t just average depression or anxiety. I remember telling him once, “Just because I’m eloquent doesn’t mean I’m not crazy.” Guess who was right?

    • ashleyleia says:

      The essence of insanity is differentiating right from wrong (and therefore inability to have mens rea), and I think there’s a big difference between being so ill that one is unable to distinguish the two, and knowing that something is wrong in the eyes of the law and not seeing that as an obtacle.

  8. Johnzelle Anderson says:

    Very well written! A lot of the misuse of these terms relates to ignorance. You a great job showing different angles of the issue

  9. M.B. Henry says:

    This is very very interesting – and also horrifying what people are able to do to each other 🙁 I often can’t watch the true crime type stuff on TV because it’s just so disturbing – a very educational breakdown you’ve written here!

  10. mentalhealthfromtheotherside.wordpress.com says:

    Well written article Ashley, clear and concise. Unfortunately psychopathy describes one or two of my exes and l’d be surprised if people haven’t met at least one person in their lifetime who fulfils the criteria.

    Psychopaths don’t live by social rules or expectations and it’s well documented that they often tell lies, have inflated view of themselves, they can’t control their impulses and they feel no guilt or regret for actions that hurt other people. However, over here in the UK, psychopaths like Harold Shipman (“Dr. Death” who killed 218 patients), Charles Bronson (known as the most violent prisoner in Britain) are sent to psychiatric hospital prisons as though they have a mental illness.

    Your island for psychopaths sounds “just the ticket.”

  11. Hannah Celeste says:

    Fantastic post. I wish peoples’ go-to characterization of serial killers wasn’t always “crazy” or “mentally unstable” – just another way that people unfairly (and inaccurately) stigmatize mental illness. Love that you are using your blog to call out and clarify this.

  12. carol hopkins says:

    I think labeling such criminals as psychotic is a way of dealing with things that are so shocking and unbelievable. Perhaps it is a security blanket, so to speak, to help us deal with the horrific things humanity does to one another.Otherwise we would have to consider that this darkness that enables horrific crimes can be done by almost anyone and that is something that makes us reel. Labels give us a sense of meaning when things seem “unreal”. that’s my take in any case.

    • ashleyleia says:

      I think that’s very likely to be the reason people do this, but when labels give a sense of meaning that is false, that ends up perpetuating stigma against people who actually do experience psychosis.

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