Psychiatry & Psychotherapy Podcast - How To Identify A Female Psychopath

Episode Date: May 1, 2021

On this week's podcast, I interview Jason Smith, Psy.D., A.B.P.P., Chief Psychologist at a prison in the United States, and Ted B. Cunliffe, Ph.D., who is a clinical and forensic psychologist at a private practice in Florida. Together, along with Carl B. Gacono, Ph.D., ABAP, they have written the book Understanding Female Offenders, researching how female offenders' psychopathic behaviors present differently than in males and how we can address biases we may have in order to identify, assess, and treat these women. By listening to this episode, you can earn 1.5 Psychiatry CME Credits. Link to blog. Link to YouTube video.

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All right, welcome back to the podcast. I am joined today with two PhD-level people, Jason Smith, a C.D., a chief psychologist in a prison in the U.S., and Ted Cunliff, who is a PhD clinical and forensic psychologist in private practice in Florida. And they have written a book on understanding the female offenders. So this is about psychopathy. This is about antisocial personality disorder. in the female population specifically, which when I saw this as like a book that I could potentially interview people with, I was like, man, this looks really interesting. I want to take a look at this because we've had other people on Dr. Cummings, who's like an

expert in psychopathy, the biological aspects. But I'm really curious, like how do females present differently? How do we treat them? How do you treat them? So yeah, welcome to the podcast. Thank you for having us Yeah, so I wanted to start out And tell me why has the female population In the jail system gone up And it seems to have gone up like quite a bit In the last like 50 years

Well, I think it has to do with Just being Coming a little bit more aware that females can kind of commit crimes I would say is kind of what is kind of increased some of the population for them going up. But even though it is going up, it still hails in comparison so much to the male offenders. So it's still like 93% incarcerated are males and 7% or females. And I believe it just has to do with just starting to become more focused on their crimes and that they commit, which I think has increased some of the numbers in terms of them being in

incarcerated. Okay. Yeah, and Ted. I think I would add something to that, Jason. Mm-hmm. Yeah, go ahead. And that is just, there's a lot of bias, as we wrote about in the chapter. And I think historically, women have been seen as been infantilized.

And there's been, especially years ago, there was an idea that women couldn't possibly commit crimes or be held accountable just because they're women. And I think that that's decreased somewhat. The bias is still there, as we've written about. But I think they're being seen more now as capable of committing crimes and being held accountable for those. Especially for the sex offenses, too. I think that gets a lot of in the popular media, too, seeing the teacher kind of with sexual offenses against their students. That one has seemed to definitely kind of been increased and it's kind of been come more of the forefront. See a lot of stories. And I think that's helping kind of break down as Ted was talking about some of the bias in terms of that women can't do these certain types of crimes. But I think it is

becoming a little bit more understandable and seen in the popular media, which I think then also in terms of them just getting incarcerated, which I think is increasing. the numbers. Yeah, so it was something like from 1980 to 2017, a 750% rise. Yes. In the amount of women in the prison system. And there was also a rise in the amount of males in prison system. So it seems like a lot more people are put in jail and longer, like, you know,

the sort of the prison industrial complex of sorts that someone might argue. Yeah, I think that would just go back to also the policies from the 80s. and drug crimes and stuff like that, I think. And substance abuse crimes are very common in female offenders, so that could also possibly be causing some of the rise as well. But yeah, it's probably more also to the laws in the United States from the 80s on. Also, you talked about how there's been more people with mental illness in jail, specifically because there's deinstitutionalization of, you know, places to put

them. Yes. For more of the people who are very unstable. I see it's so hard to keep some very ill person in a psychiatric hospital longer than, you know, five days. It's like, good luck, arguing with the insurance company. And so I see kind of the jails and the prisons, unfortunately sort of fulfilling this place in the U.S. in the U.S. as a place that mentally ill people end up. Yeah. In Miami here, the Department of Corrections in the Miami-Dade County Jail is the largest single provider of mental health services in the entire county. Yeah. And I think we talked about in the book, too, I think it was like 44 states have more mentally ill people in their prisons and jails than the state hospitals by a large margin. So,

Yeah, it just goes back to community health and state hospitals that are just not being able to house them for longer periods of time. And then they commit crimes and they go to prison and then they get seen in prison for mental health reasons. And there's a lot less just community-based psychiatric units than there used to be. Yeah. A lot of ours have closed. I mean, right now we're operating on three in the entire campus. County, which is probably down about, I'd say about 70, 80% what it was 30 years ago. It's unfortunate, you know, the resources have shifted to this model that isn't always the best for treatment.

Yes. Okay. Well, let's, since you guys are experts on this stuff, I really want to dive into and learn from you guys about psychopathy, about antisocial personality disorder. first of all, just for people who are like maybe wanting to know some simple definitions, how would you say, like, what is the difference between antisocial personality disorder, you know, represented in the DSM-5, and then psychopathy, which is not in the DSM-5, how would you differentiate those two? Well, psychopathy is a very old construct. There's a lot of confusion about the term, as we've written in the book,

and we've written in a lot of other places. Basically, what you're talking about when you're talking about criminal behavior, you're talking about three things. Psychopathy, sociopathy, and antisocial personality disorder. Psychopathy is a very old construct, concerns personality aspects, such as affective kinds of things, interpersonal kinds of things. And antisocial personality disorder is really describing criminal behaviors. It's not actually accessing personality very. variables. And sociopathy is actually very close to antisocial personality disorder. So that's an easy way to distinguish it, is that psychopathy is really talking about the personality as well as antisocial,

and the sociopathy and the antisocial, which the sociopathy is really the precursor to antisocial personality disorder. They're very closely linked. And it's more related to behaviors. And also an additional point, I know we'll probably get into this a little bit later, which has to do with how do males and females differentiate. Well, in males, the central organizing factor from a personality point of view is the narcissism. So when we think about a male psychopath, you know, Carl Jocono and Reed Malloy and Bob Hare and on and on and on, lots of psychopathy researchers have written about this idea that a psychopath, a male psychopath is basically what Reed Malloy referred to as a malignant narcissist.

So you've got the narcissistic personality disorder along with the antisocial personality disorder. But with women, you don't see a lot of narcissism. It's a very, very low base rate amongst female populations in general. And what you tend to see is a lot more borderline personality disorder, histrionic personality disorder. So in the female presentation, that's the organizing personality aspect, is that histrionic borderline continuum combined with the antisocial personality disorder, as contrasted to males, which is more narcissistic, paranoid personality disorder

combined with the antisocial. A new study came out that showed that 100% of ex-boyfriends have narcissism. Ex-boyfriends. As surveyed by a therapist, actually. No, it's a joke. So it's something I'm seeing more and more in our culture. So I think just if you could define, like, what do you mean by malignant narcissist? Because it seems like everyone thinks their ex is a narcissist.

Well, narcissism, of course, is a pathological self-focused, somebody that has a lot of empathy problems because they're so focused on themselves. They don't really consider other people. They don't really interact with other people as equals, that they're kind of, you know, you think about Milan's ideas of elite narcissism and these people that are just very, very grandiose and self-focused, etc. Now, with a malignant narcissist, you're factoring in the antisocial personality disorder there. So not all narcissists are antisocials at all. You can be very narcissistic and not really have violent impulses or be someone that enjoys violating the rights of other people. But when you put those two together, that's when you end up with your malignant narcissist, which, Ma'an, under his typology, refers to it as an antisocial narcissist. And so when we think about psychopathy in the, let's say you took like, you know, this antisocial

personality disorder population that ends up committing crimes that ends up in jail, what percentage of those people likely have psychopathy? It depends on the security level that you're at, but on average, the data shows about 20 to 25 percent of people that are in prison are psychopathic. So most people that go to prison may meet the criteria for meeting antisocial personality disorder. Carl likes to call it like it's finding ice in your refrigerator, right? When you go to prison, you're going to find all these antisocial personality disorder people. But what sets them apart is about 20 to 25 percent meet psychopathic personality. And we define that by using the PCR, which is 30 or higher. And for females, it might be a

little bit lower. It might be maybe like 15 to 20 percent, but it's still a pretty good percentage differentiating between antisocial and psychopathic offenders within correctional settings. And I think another, an easy way to think of it is that all psychopathic offenders, are antisocials, but not all antisocials or psychopaths. That makes sense. Do you think that's the case, though, because don't you think you could be a psychopath and not break the law? Yes.

Yeah, we have the successful psychopaths. Successful psychopaths. Abiak has wrote about that as well, yeah. But not all antisocials break the law or get caught for breaking the law either. Okay. So maybe that's the distinction that when you look at Paul Babiak's stuff, you know, he wrote the Snakes and Suites book with Bob Hare. Yeah. And all of his data are these guys that are on Wall Street.

Do you think there's an overpopulation of psychopathy among executives and Wall Street and a lot of these things? Do you think that there's real data to support that or is that more of a cultural myth? Well, Babiak's data supports that. Yeah. Yeah. How strongly? Like, what percent are we talking about? So there's like, what, 1% females in the general population?

2% males? I've heard that. So, but like, how much higher is it in, you know, those places where, how much higher is it in places like Wall Street or, you know, executives of companies and stuff like that? I don't know if that exists, actually. Yeah. I don't know if that data exists. Yeah. But there, obviously, there's probably some. But yeah, we don't know the percentages. Well, I mean, you think about those kinds of careers that those would attract psychopaths, somewhere there's a lot of money, power, etc. Politics is another example.

Law, maybe. Law. Yeah. I mean, that was kind of, you know, in Cleckley's book that he wrote in 41. And he did several updates on it. But in there, he takes a case study approach. He was a psychiatrist. And in there, he talks about the psychopath as businessman, the psychopath as psychiatrist, the psychopath as a lawyer,

and gives lots of different examples of how psychopaths that were in various different professions. Yeah. Okay. So you have a chapter talking about bias in diagnosing and understanding and assessing. And I really like Table 2.1 talking about the different logical fallacies and thinking error. Breakdown, like, why did you think this was so important to put right at the beginning of the book to really kind of explain this before you jump into the other stuff? Well, Ted was the first author on it. But we thought it really did set up the book very well, especially to kind of start about talking about some of the myths.

And then it would lead into our data and then our assessment and everything like that. Ted put in some great work. Carl had our second author. He had some really good ideas about just kind of looking at some of the scientific method stuff. And then Ted found all this great data he did went through everything, looking at suggestibility. and all these fallacies and biases. So what are the kind of fallacies and biases that the listeners might have

coming into hearing about female psychopathy? Well, you know, we started off that particular chapter just talking about general biases that would be applicable in almost any endeavor and ones that specifically apply to mental health in whatever type of research that you're doing or whatever type of clinical endeavor. And there's a whole range of those. You know, we kind of started off talking about the psychologist's fallacy, which, you know,

was first pointed out in the, in the 1800s. It's the assumption that one's observations are correct, right? Exactly. Yes. Right. Yeah. And, you know, all kinds of things like, confirmation bias, which what we're looking at there is kind of having a theory going in.

And you only look at the data that supports your theory and you don't look at the data that doesn't support your theory. So, you know, that would apply to diagnoses. And for females in particular, right? So we talked a lot about how male psychopathy is like the general view that people have when they think about assessing females or diagnosing females. And by thinking, all right, this is the prototype, they're going to be narcissistic, they're going to be callous, they're going to be trying to take over the interview. And if you use that as your cognitive heuristic when you're going in there,

you're going to miss a lot of the important stuff that when we assess with the females, they do not present as this narcissistic, overt, callous, trying to take over the interview. It's actually, they may play a little bit more coy. It may be a little bit more seductive, self-focused. So I think the psychologist fallacy, I think, is a big one that plays a role, especially if diagnosing, assessing, treating female offenders. Yeah, I mean, that's kind of how, just talking about myself personally, that's kind of how I got started on it,

was that I was working at a female prison, a female federal. prison in California. And I'd already, before I went to graduate school, I'd actually read a lot of stuff on psychopathy. And I went to the prison and I was looking around and there were these women that were getting into a lot of trouble, doing a lot of quote-unquote psychopathic kinds of behaviors didn't really seem to have any remorse. Yet they didn't present like what was being described in the psychopathy literature. They didn't have that kind of callous presentation. They were callous, most definitely, but the presentation was more of a kind of a friendly callousness. You know, like where they kind of portray themselves as victims and there was a real need.

You know, when I was doing that in California, I was collecting my original, my first bit of research for my dissertation. And I had a female co-researcher. We were collecting all the data together. And it was really fascinating to watch the women's interactions with her and me, which was completely different. And they were very, very concerned about what this other researcher. Amy Muntz, what their reactions to her. Like they were very, you know, we were doing a PCR inter-rater reliability, so we would do the interviews together.

So usually one person would take the lead and then do the interview and the other person would kind of sit in the back, the room and observe and, you know, that kind of thing so that we could score these, the PCR together. And even when they would be talking, they would be looking. over at her, like very interested in her approval, coming up with excuses for their behavior, just very sensitive to how they were being perceived by another woman. And I think that that's something that I've observed over the years repeatedly, is that they're much more, you don't get the sort of what Bob Hare refers to as the

braggart coming in there and just bragging about himself. and all those accomplishments and, you know, this kind of thing, that what you get with the female is that Jason was just referring to as more coy, kind of a seductiveness, portraying themselves as victimized, things of that nature to kind of gender and sympathy. And those are, these are key aspects when you're interviewing these women and when you're treating them, especially, like your approach is much, different kind of a dry kind of just the facts ma'am kind of approach that you would take with a male

psychopath would would not be advised with a female psychopath you're very unlikely to get good information yeah i want to get into the um the psychopathy checklist i want to go kind of item by item actually like you do in the book and talk about the difference between the male and the female i think it would be a good way to organize. But before I go into that, maybe give me a couple sentences on the psychopathy checklist, what it is, how is developed, is it reliable, how reliable, and how it's been useful in research. Okay. So Bob Hare was the one that created it, kind of using up until the 1980s when he was first kind of creating it, there was no real measure of psychopathy.

Cleckley, as we talked about, had some lists of items that were, he was describing. But Hare was the one that really put the research and the time into the interview. And it's an interview. And it's not a self-report, which is very key, especially when you're assessing a population that lies and manipulates. He thought it was best to put in an interview. So in 1980, he started collecting his data for, the interview process, and then it was revised in 91, and then 2003, it kind of came out.

It is very reliable, it is very valid with males. As we kind of talk about in the book, there's some things that might be a little bit different for the females. But in comparison to a lot of times researchers or even clinicians use the personality, the PPI, which is a self-report measure, or they try to use the PAI to diagnose psychopathy. PCR is the only one that shows valid ways of kind of comparing groups of psychopaths versus non-cyclopaths, as well as self-report is just, it's not going to get the same as an interview. One thing that I'll talk about, though, in the PCR, you have to do a file review before you do the interview. A lot of times, researchers will not do a file review and don't have any

corroborating evidence. So when they ask the questions, they just take the inmates' word as valid. So, for example, a female would say, if you didn't do a file review and see that she had a whole list of charges, and you ask her, have you been arrested it before? And she says, no, you would score that as zero. But if you actually looked at the record and said that she had all these different categories of offenses, obviously your numbers are going to be higher. So it's very important to make sure that you do the file review before the PCR interview, which makes it very valid and reliable. And Ted probably can add more to that too. A couple of things to add. Just that these inter-rater reliability are extremely high.

these are up around 0.98 liability. Is that when the two people are in the same room doing the interview? Or is that when they're doing separate interviews? Because I imagine that when they're in the same room watching the same interview, that would be high. But then if they're doing their own interview, is it lower? Well, most of that data is actually from file review.

So not actually being present in the interview, but going over somebody's notes. This is what I did with Carl Giacono, you know, we didn't actually talk about this, but this is a three-generational group you've got here. Yeah. Carl Gicono was my major professor and supervised my dissertation. Wonderful. And then I went to academia and I was running a forensic program and Jason came into the university and he was one of the students there. And he was my TA for four years.

And through that, I introduced him to Carl, and now the three of us have been going along here. So that's a side issue. But I think that most of this stuff was done going Carl and I did my inter-rater reliability. These were detailed notes that I'd taken during the interviews and submitted to him all of that data along with my scores. and then he would look at all the data and he would score it and we would do an inter-rater reliability. And we did the same thing with Jason and his data. So I think routinely what we were doing there with Amy, what I was doing with Amy months was you want to do inter-rater reliability on all the PCLRs you do.

But in that case, we were just establishing, taking 20, doing 20 interviews together, and establishing inter-rater reliability. So when you think of it, you know, the 0.98 that's referred to in the PCR manual, those weren't interviews that were done with two people in the room. Those were file record. And even, you know, Andrew Wong has actually demonstrated that you can do a score of PCR without an interview if you have enough information. Not that you would want to do that.

But just to kind of touch on the point that Jason was just talking about, about the importance of doing a record review beforehand. And I completely agree with what Jason's saying in terms of, you know, that's important information to know going in, especially when they're talking about their records and that kind of thing. But when I do them, I always, I use that information to challenge them. Usually I do that at the end of the interview. because some of these items that when you're talking about manipulation,

pathological lying, poor behavioral controls, all of these kinds of things, that it's one thing to say to the person, oh, well, you know, do you have issues with getting mad? Do you flip out on other people, you know, looking at data to suggest they've got poor behavioral controls? And there's a difference between doing that and trying to recreate it in the middle of the interview. So that's something that I always do where I kind of pretend like I'm really upset that they've lied to me. Oh. And I'll say stuff like, you know, this is just beyond the pale. I just can't believe this. I can't believe that you're coming in here and you're lying to me like this. Like this just goes to show you, right? But I'm like this kind of thing. And just to see what

they're going to do. Like somebody that's a two is going to go, you know what, Doc, why don't you just take the next bus out of here, you know, blah, blah, blah, versus somebody that's low is going to go, oh, well, hey, sorry, you know, try to repair the relationship, that kind of thing. So I think it's very valuable information to have going in. Yes. Oh, man. Yeah.

I once had a homeless person. I saw them and I made them food and they knew where I lived. So they came to visit me at 2 in the morning to ask me for money. And me wanting them to get away, I gave them a little bit. And then they came back with a pie. And they had a story. It was a sad stop story. And I thought, hey, maybe this is real.

You know, so here's $40. So I was telling my rowing buddies and two of the other guys had this same story from this guy, right? So I'm like, oh, man, I was con. So he comes back with a pie and he's like, my wife made a pie for you to thank you. You know, he was working on the long con, right? And I look at the pie and it's like a Safeway pie, right? So it's not like his wife made this pie at home. And I took his pie and then I said, you know, your line.

to me, you've told this story to many people, you know, and I'm really sad because, man, I trusted you. And he's like, that's not true. And, you know, I took a picture of him. I texted to my friends real quick. And they confirmed it was the same guy. And I'm like, look, they're confirming it was you. And he got really, really upset and left. I was so devastated that someone had like swindled me, you know, here I was trying to do good in the world, feeding a homeless person. Yeah. Well, I think that's one of the things that we talked about in the book in terms of this idea of armchair kind of psychopathy assessment where you get people that aren't clinicians or if they are, they have clinical background. They do very, very little in the way of actual clinical work anymore, apart from supervising people. But when you're a clinician, you get just like you're describing. You get. full frontal you know like the idea like if you if you go to work with this population if you go to a prison going to the prison and i used to tell the students all this this all the time so it's not a matter

if you're going to get fooled it's just when you're going to get fooled yeah yeah um so i ate his pie it was pretty good i was sad and i ate his pie i was like afterwards i was like maybe i shouldn't eating that pie. Oh, man. So, yeah, I was thinking about, like, what is the purpose of educating, like, the general therapist about this content, right? And some of the most painful patients, the most painful patient interactions are people who want something from us.

They want to boister their disability claim. They want to, they want us to get to sign off on long-term disability. we don't really feel they need it, you know? I had this one client a while ago who, like, I'm going to change some details here, but she had a lawsuit ongoing for a head trauma that she had. You know, and I work, my specialty is like, or part of my specialty, I guess, part of its psychotherapy, part of its, you know, people with medical and psychiatric issues, right? So I run this IOP partial program for those types of people.

So I've seen a lot of TBIs. and I've seen like what real tbis look like and this this woman did not have a tbi right it was just so obvious but she was she was suing for a tbi and um she had no contact with her kids her husband was uh you know she described him as like this evil person and um you know after a while like it seemed like there were some lies occurring you know like incongruent affect like 10 out of 10 depression but She's been in the program like five weeks. No one at five weeks still had 10 out of 10 depression. Superficial, but then sort of disconnected from people.

And as I was reading your stuff on the psychopathy checklist, which will go through, I had this person in my mind just thinking like, oh, wow. That's interesting. That's really interesting. I actually did that with an offender once. Okay. Female offender. Because I was actually doing treatment with her and she was a psychopath.

Okay. And, you know, you don't want to do insight-oriented therapy with psychopaths, obviously, because they're not really capable of that kind of thing. And you just end up getting manipulated. But I have done treatment, very behavior-focused treatment. So she sat back and she goes, yeah, yeah, give me the list, right? give me the laundry list. So I kind of went through this.

I went through all the items with their and she goes, yeah, yeah, I've got, yeah, I think you're right. Yeah, I've got that. Yeah. Uh-huh. Yeah. Oh, dear. Okay. Let's go item by item because I really want to like,

I think this is going to help sort of educate and sort of open our eyes to what is psychopathy. So item one, glibness. and superficial charm. So how do you see this differently in females and males? So for the males, Hare kind of talks about it as kind of this used car salesman, like boastful, you know, just kind of just work in the room, things like that.

But overt and boastful in terms of that. But for the females, the superficialness could be the coy, the seductiveness. They could kind of do some of their, you know, like trying to sell things, but it just presents not to this like overt kind of level of things. Very kind of using their appearance to kind of charm the person, kind of that superficial charm. I'll give one example. It was probably, I was doing research in a correctional setting. I think it was like the first female that I interviewed.

and she didn't realize she was coming to meet a male researcher. So when she found out that she was in the hallway in front of all the other female psychologist, she stopped, she put her hair up in a bun to kind of make herself kind of appear more attractive or physically. Appearance was very important to her. And then the next time I met with her, she knew she was coming to meet with me. She was all makeuped up. She had earrings on.

Her hair was all done. again, it's kind of that plain, that coy, seductive, kind of superficial charm that we see normally with these females. Yeah. And I think it's, I think with the females, it's much more subtle. Mm-hmm. You know, it's like, it's kind of a wink, body posture, that kind of thing, you know. Like I, I love shoes.

And, you know, I go out of my way to spend a lot of. money on really nice shoes. So I remember this one female psychopath, you know, she just zoomed in on my shoes. Just kind of like, oh, wow, wow, those are great shoes. You know, like a lot of doctors come in here

and they, you know, they dress like shit. But I mean, look at that. Those shoes are great. Yeah, those are really terrific. Yeah. Yeah. She got you pig, man. Exactly. She was like,

she was she observed what you really found fascinating what you enjoyed what you what you were into oh yeah compliments and sort of that puts down the other people you know at the same time right yeah right evaluation is huge they they and they do it subtly like a passive aggressive style build you up but devalue you devalue the other people right it's a little bit of like stroking your narc maybe a little bit of the narcissism we naturally have, right? It's like the, you know, devaluing all other psychologists do not have the style that you have, you know? And try to split you from your other colleagues too, right? So then you're thinking out like, you're, oh man, I'm so much better. And then that's going to play a role, especially if you have to

interact with them in a long-term basis. Yeah, they're really good. And they do it right off the bat. It's kind of like they just go into that mode, like right off the bat. I was working. I was working at a prison in Florida here, female prison. And I could hear some of the female inmates talking amongst each other out in the hall. And one of the older females was talking to one of the younger ones. She goes, look, honey, you got to lay a foundation. Right. So you go in the first couple of times, you know, you do this, this, this.

And you're kind of laying a foundation. because, man, if you get a DR, like a disciplinary report, if you get a DR, you're going to want them to say some nice things about you. That's good. That's really good advice. Yeah. You said when strategies fail to engage the examiner, the underlying malevolence may surface in the form of aggressive devaluation.

Tell me about, give me like a story. I want to hear a story about that. Well, yeah, I can think of one. Very infamous psychopath that we have in our data set, which I'm not going to actually go through exactly who it is. Although it wouldn't really matter that much because she's since passed away. But, you know, I did the interview. I did the psychopathy interview.

And, you know, at the end of the interview is when I, the end of the interview is when I typically challenge people. because if you got somebody that's high and poor behavioral controls and then they go off on you in the interview, then the rest of your interviews is done, right? She's not going to get the information. So I always do that at the very end, just in case. So anyway, so I was doing that with her and pretending, you know, that I was upset that she'd been lying to me, that kind of thing. And then, you know, through that she became clear, you know, that I was sort of, in her mind,

least was kind of this was the first time I was actually seeing her for who she is and then so then you know she got very upset she kind of lashes back at me and glares at me and she says you know you better give me a good evaluation because if you don't I am going to come back here and you are going to rue the day you ever crossed me it's like okay right? I mean, that's the kind of thing where you kind of get this sweet presentation. And then as soon as you call them and you bring it up to them and you put it in their face, almost like a mirror that you've kind of got them, then that's when you get the, you know, and it's all related to what we were talking about earlier in terms of this need to be approved,

approved of, which you don't see in the men. Like a man would probably, if you confronted them like that, they probably laugh, like a true male psychopath. No. You just kind of, ah, you know. You got me, Doc.

Yeah. You got me. That's right. Yeah. Yeah. But Doc, let's talk about the game last night, huh?

You know, switch the term. Exactly. Okay. So you talk about sexualized verbal, and we're still talking about glibnus,

superficial charm. You talk about sexualizing the staff to get money, drugs, preferential treatment. So how do you train, you know, psychologists going in there to not fall prey to be sexualized? Well, I think it has to go with boundaries. I think that that has to be the biggest thing. And then just letting them know the environment that these women, you know, they're really good at the glibness, the manipulation and things like that. And to consult,

Like if they have any questions, I told all the psychologists like, hey, please, reach out. They want us to split. They want us to be off on our island. So if we consult, we can stop the behavior. Kind of like you did with the guy that was bringing you to the pie, right? You went out, you reached out, and you found that this guy was doing it to everybody. So telling the psychologist that it's a part of your job, but setting the boundary and working collaboratively and stopping this is probably the best strategy working.

Definitely in a prison setting where you see it all the time. I think also from an awareness point of view, one of the things that I always try to do myself and people that I've supervised have advised them to do is pay close attention to the counter transference and what it feels like to be in the room. Yeah, what is that countertransference that you're becoming wary of? Like a predatory, a dangerous predatory psychopath. The countertransference is you feel like a piece of meat. And you're looking over your shoulder making sure there's an officer there, right,

in case this guy gets violent with you or a woman gets violent with you. But also the sexual aspects, the same thing. Like if you start to feel flattered and you start, you know, start shifting in your seat and you're just kind of like oh yeah i mean these are things to pay close attention to yeah yeah this something Freud talked about a lot right right that's the sexual transference yeah yeah yeah and you know if they're if they're more skillful which probably the most skillful are not in a jail and um and then they're they're probably skillful for a reason okay Item two, grandiose. So this is still the psychopathy checklist. Item two is grandiose sense of self-worth. So maybe we could talk about that first in the males. You talk about bravado, not aware. They are not flattering. They take control of the interview, dominance, contempt for others, self-assured, opinionated, cocky. Anything else you want to add to the grandiosity of... It's their narcissism. They

are that that is where it comes out really they're so grandiose you know they they'll they'll say that they do all these great things just to kind of pump themselves up yeah would be the male version which is also tends to be the the view that most people have of what psychopathy is this grandiose kind of person and then when we we transition to the females it looks completely different um for the females yeah i think also Jason is this lack of insight. A big part of that. Yeah.

So, you know, when I assess this item, I always say something, you know, like the following. Well, hey, you've accomplished a lot. Can you tell me what some of your talents are? Like, what are you good at? Yeah. And then they'll go on and on and on, almost to the point where you have to kind of go, okay, okay, yeah, I got it. That's enough, right?

And then you ask him, okay, well, is there anything that maybe you think you need to work on? And then they'll just be like completely stumped. You know, they'll be like, oh, boy, I don't know. Gee, that's a really tough one. Yeah. Things that I don't like about myself. Is that what you mean? Um, I don't know.

I don't know. I can't really, uh, well, I don't know. I can't really. I don't know. And so there's that kind of lack of insight. Yeah. I mean, this is somebody that's, you know, in some cases,

doing life in a prison for killing people, right? And still they're just incapable of coming up with any of their shortcomings. Or just being a prison in general. You've committed a crime. There's probably something that went wrong in your life, right? That you need to work on. And they just don't get it. Yeah.

But you know, it's interesting in like outpatient stuff i'll i'll get some patients that maybe have a flare of the the grandiosity it's hard for them to seek treatment period you know they seek treatment for other reasons often um help me deal with this person in my life who you know i'm perfect and they're just like i years ago had this person who I tried to reveal that there was two sides of the dysfunction in the marriage. And he was gone. I never saw him again.

I never saw him again. And I, you know, of course, I was pretty young in my profession at that point. And I was like, man, I guess too much truth, you know? Yeah, they didn't want to hear it. You had a quote in the book, unwanted truths are not popular. Sherlock Holmes. Yeah. That was a big theme in the book.

book, not only for the population, but maybe also some of the people reading it. Well, let's talk about females, so that grandiose sense of self-worth, how do you see that and differently in females? This is a big one, and Carl kind of started in his 94 book kind of looking at it, but Ted really, and his research and his articles in the late 90s or early 2000s, calling it not grandiose sense of self, but more pathological self-focused. meaning they like looking, talking about themselves, liking being the center of retention, life of the party. But they have this kind of underlying, like, damaged self. So they are less likely to list a whole bunch of things that they're great in.

And it might be more superficial thing. Like I like my hair, a physical feature. But it tends to be, they like this attention. And Carl's kind of talked about, Ted's kind of talked about it. they like looking at themselves in the mirror, but when they do, they don't like what they see, which is the opposite of the male psychopath. They love looking at themselves in the mirror, and they think they're Adonis and perfect, and nothing is wrong. So the pathological self-focused is much different for the females, and it is one of the big differences between the two

males and female psychopaths. And it's something that actually drives a lot of their thinking and their behaviors. Is this kind of idea of chronic self-criticism where they're very concerned about how they're being portrayed or being seen by other people, what other people think of them. They're very almost consumed by it versus the males. They're really not consumed by that at all. Like they don't really seem to care.

and you know if if they're confronted with somebody that obviously doesn't share the same opinions of themselves then they typically well well it's jealousy or you know i mean it's obvious how awesome i am how could anybody not you know whereas that's not the kind of presentation that you get with females at all so i don't get that i'm struggling with how that's grandiosity though in females is it because it's a or it's it's it's that constant look that constant self-focused the constant sort of need to maintain an image yeah we think we we don't think a grandiose really captures it well on female so that's why we would we just kind of change we would think about modifying the item name even for that that the grandiosity really what hair is kind of described in the PCLR

really doesn't describe the female as much. But they do, again, they do share this intense kind of self-focused, both males and females, but again, how it's kind of portrayed as different. One of the lines you said is when talking to a female about STDs and stuff, she said, my blood is cleaner than Jesus. Yeah. So there's a little example of the grandiosity, right? Oh, that person, that was, that's, that's.

the highest person I've ever on the PCR ever tested. She was 38.9 and the only reason why she didn't get 40 is because just didn't have enough data to, so I had to admit a couple items. But she, oh, she, yeah, she was severely psychopathic. But yeah, she, she was definitely grandiose, but she also, again, like, had that self-focused, but also had some of this damage sense of self. So she was kind of our prototypical female psychopath, at least from my interviews. And Ted has his own as well. So, okay, let's go on to item five, conning and manipulative. The quote from the psychopathy checklist is the use of deceit and deception to cheat, bilk, defraud, or manipulate others, the use of schemes and scams motivated by desire for personal gain, carried off in.

a cool, self-assured, and brazen manner. So, yeah, so the conning manipulation for the females tends to kind of use, going back to kind of the superficial, kind of using the sex as a kind of wave to kind of manipulate their appearance as manipulation tactics tends to kind of be where they're kind of coming from for their conning and manipulation. Drug dealing, they may be doing some drug dealing and things like that. selling them less than they would normally in a drug deal or burning them or things like that. And tends to kind of be some of the conning manipulation kind of behaviors.

And Ted might want to speak a little bit more into some of the stuff that he's seen as well. But sex is a big thing in terms of how they manipulate using their appearance. I think the important thing to keep in mind with all of it, and it has to do with narcissism. or lack thereof in females, is that you don't get this overt kind of out-in-your-face kind of presentation. So all of the manipulation is another example where it's very subtle in a lot of cases. And, you know, because there's so what Carl and I started calling pseudo-dependency way back when,

This is in the late 90s or early 2000s, this idea that they're very, very concerned about how they're being portrayed. So, you know, the females are a lot less likely to actually tell you the kinds of manipulations that they've done. Because women, you know, I think all guys, just because of the male culture, all guys can kind of relate to antisocial, at least on some love. level, whether it's involvement in sports or just being with other men. Like there's that kind of, you know, being tough, you know, being a man, that kind of thing. And with women, you know, like my wife, for instance, I mean, she's completely disgusted by like

female offenders, right? It's just like, ew, that's disgusting, you know, that kind of thing. And you don't get that when men think about male criminals as much. So they're very concerned about how they're being perceived by other people. So the manipulation tends to be very kind of subtle and they're a lot less likely to tell you about the kinds of things that they've done and how they've screwed people over, et cetera. And usually they'll have an excuse for it. A rationalization. Someone made me do it or, you know, it was on drugs or things like that.

And yeah, so you have to kind of tease that apart, take their rationalization out, look at that. the data, look at the files, look at how other people observe the behavior. I think it also goes to the interview style that you adopt. Like you kind of have to come across as very supportive and non-judgmental. Yeah. Yeah. In order to get them to actually talk to you about what's been going on and what they, you know, in order to access the information for some of these items.

You talk about pseudo- emotionality and superficial concern for others in interest of secondary gain, specifically mirroring. They want to be mirrored. Yes. And the mirroring that you're talking about, is that the same thing as like they want this image that they're holding of themselves to be mired by you? They want you to see this image of them.

Is that what we're talking about or is that something else? They want to be emotionally mirrored. like they they want you to to kind of like cheer lead for them like that tends to be a lot of the times you know that they come in here they can't regulate their own emotions so they they for my experience they they come to me you know this is what's going on hey build up my self esteem help me regulate this emotion mirror back kind of like that I'm doing okay but you know I just going through some stuff but it's going to be okay so they kind of use and it's a kind of very emotionally draining in terms of kind of the counter transferances.

They want to get this self. They have this damaged view of themselves. So they kind of want to get propped up. Hey, what I'm doing is okay. So the mirroring kind of is like kind of cheerleading for them and giving them that their emotions can be regulated by somebody else because they tend to, a lot of the times in treatment, that tends to be the case. They come in.

They're all over the place, labile emotions. and by the end, you know, there's a little bit sense of stability short-lived, but in that session, it's just a way to kind of tease that apart and mirror back that I'm an okay person, even though that they've done all these crimes. That's what they're trying to get at with that pseudo-emotionality. And then Ted, this was one of the findings that he found, all his research, was that really that this shallow kind of affect that they may present like they have this kind of deep felt emotions and they have this labile emotions, which you might think, oh, they have a full

range of emotions. But Ted's research really did show that it's very short-lived and it's not as deeply felt in terms of that. That's why we kind of called it pseudo-emotionality. And Ted probably can add a little bit more to that. Yeah, I think it's this concept of pseudo-dependency plays a big role in this. And, you know, what Jason's saying is completely, you know, I completely agree with that 100%, that they're looking for another, an interaction with another person in order to build up their sagging sense, they're sagging self-esteem, their sagging sense of self. And, you know, this is where the, the, the borderline personality organization kind of comes

into play here, that there's an emptiness that they have and they feel empty. They'll tell you that they feel empty. And they're looking for somebody to come and help fill the void, whether that's through interaction or support when they come in, things of that nature. So these are all, you know, these are linked concepts in terms of, you know, what would be driving some of this kind of behavior that we see. Yeah. A couple quotes here. I am exceptionally, emotionally, intelligent. How I manipulate emotionally, I get like a virus. I infect them. Yep, that was, that goes back to the Jesus person as well. Like I said, she had some really good quotes, but she she knew how to use emotions.

She knew what the people are looking for and how she's supposed to react and use that to manipulate that type of behaviors. It almost feels, Jason, like she knew that you wanted something a little bit more salacious. She knew that you wanted something a little bit more like, you know. She also mentioned she've read books about Ted Bundy and all these things. So she was more than happy to answer some of these questions. So I think, again, I think she viewed herself on the same lines as Ted Bundy and some of the other serial killers. Well, actually, your comment, what you just mentioned, both of you, is kind of sums up how psychopaths manipulate in general.

Yeah. Is that they give, they are able to assess somebody very quickly and very accurately. and then they give them what they think they need as a means to manipulate. So, you know, like if somebody is like looking down and or, you know, looking at their clothes, thinking, you know, they'll say something like, oh, wow, you know, you're looking good today. Yeah, those pants are nice. Yeah. You know, like this kind of thing. Yeah. And so you're giving you what they think. You're what you need. Yeah.

They do that frequently. Lay the foundation, right? That's right. Lay the foundation. Another quote, I wasn't taken advantage of. I need certain things. All women do that use sex.

Here's another quote. Hustled pimps out of money. Another quote, I turn people into addicts. I'm a master manipulator. I make shit happen. I can get that shirt off your back dock. I'm a moneymaker in the street. I talk a good game.

Yeah. You know, they come out with it. Once you start interviewing, I mean, the interviews and all the other measures we give, kind of break down their defenses. So after a while, there was definitely one that said, like, in the beginning, like, oh, that poor guy that I manipulated, it was in his fault. By the end, she was like, yeah, that guy was stupid. He knew what he was doing.

He knew. So, you know, you come with this empathetic kind of interview style that Ted was talking about. And by the end, they kind of open up and they feel they want their voice being heard. But again, subtle, but it does take a little bit of time. But we've were able to get some, as you can see, some good quotes. Okay, item six, lack of remorse. So let me read the quote here. Experience a general lack of concern for the negative consequences that his actions,

both criminal and non-criminal, have on others. and you also kind of group this together with callous lack of empathy, which means to attribute and behavior that indicates profound lack of empathy and callous disregard for the other's feelings, rights, and welfare of others. He is cynical and selfish. So how is this different in males and females? Well, yeah, definitely those two items do kind of come together. For the females, especially for the lack of,

of remorse or guilt, they'll kind of know, like, the definition of what they should say, like when you ask them if you ever felt remorse or guilt, they'll give you back the definition. But again, it's this superficial kind of lacking of knowledge and things like that. And they'll do a lot of shame. They'll say, like, you know, my crime has hurt my family, my children. But then when you actually get to talking to them about what it really is doing, they can't give you any, any details. And then sometimes you'll see that they really haven't talked to their children since they've been incarcerated or they don't know how they're doing or maybe they gave

them up for adoption. So they'll present like they've done bad things. They have the shame, guilt, remorse, but it's still kind of that it, that in-depth lacking knowledge, very shallow kind of thinking in terms of of those specific type of emotions. And then with the callousness, the males are overt. They'll hurt animals. They'll hurt. They'll trash houses for fun. They'll laugh about it. Overt kind of callousness. We really didn't see that much with the females. There's some, but for the most part, their callousness, more kind of verbal, gossiping, passive aggressive kind of things in terms of how they lack empathy and callousness for the two. And you talked about a loner by choice for the males. Do you see often when they have this lack of remorse or they have this callous lack of empathy, they don't have very many affiliate of attachments? Is that what you guys were thinking?

And that goes back to kind of what Ted was talking about, that pseudo-emotionality. Male psychopaths can kind of be on their own, like the lone wolf kind of thing. They don't necessarily need people. But the females, some again were loners by choice. but their attachments are the opposite. They have more attachments. They need people to give them either attention or help them with their emotions, things like that. That's reflected in their offenses too.

That women are much, much, much more likely to offend against people in their social milieu. Whereas male psychopaths much more likely to offend against strangers. There's a lot more, you know, there's a lot of detachment in males. And this came out, you know, on the Rorschach data. When you look at Carl Jocono and Reed Molloy's data, you know, 91% of their psychopaths had no texture responses on the Rorschach, meaning detachment and inability to develop attachments to other people. But you're going to have to break that down to someone who doesn't know what that means. Texture.

Yeah. So when you look at the blot, they'll be seeing texture there. Like, oh, it looks soft. It looks furry. In some cases, they'll actually try to rub the blot. And psychopaths don't have that. Male psychopaths. Male psychopaths.

No. But one of the things that we found is that there were a lot of women here. who did have that. And the sample that we had about 52% of the psychopaths had no texture. But then there was another group, another 30% who had more than two. In some cases, they had seven or eight textures. So what we're looking at here is very severe dependency. And Jason, in his work, actually kind of followed, went beyond.

you know what Carl and I did it initially and started looking at some of the other dependency related scores on the Rorschach and started to find that they were having like a really high scores on those too so you know dependency is a big aspect here how do you define dependency in the Rorschach with the different variables and Or like what do you mean by dependency? Interpersonal dependency. So not necessarily how they need other people for interactions, things like that. So interpersonal dependency.

So not like substance dependency or anything like that. So more attachments and maladaptive neediness, I guess would be the good way to talk about it. And so people with that dependency, they see more textures. Is that what you're saying? Yep. Yeah, more textures. They give more texture responses when they give the, when they're given the Rorschach inkblot test.

Wow. That's, that's interesting. They have a whole vocabulary that. And more food responses. Yeah. And. Do you want to talk about the ROD? Well, there's just another scale, too,

depending on the content of their stuff that, that could look at oral dependency. And it's calculated based on how many, they give and how many responses. But those measures of dependency, whether it be texture responses or the ROD, which is called the Rod scale on the Roar Shack, those are two big differences between males and females. Males really have low scores. Male psychopaths have low scores.

Female psychopaths have high scores. And then this goes back into our differences between males really more detached, females, more attached, but it's maladaptive. It's maladaptive neediness, needing others to kind of help them with their emotions or give them attention, things like that. And it relates to these two items that you're talking about in terms of the callousness. When Jason was just giving his example of interviewing people and how they will say things on the surface that would suggest that they actually do care about other people and they have

empathy and they're not callous and things of that nature. But one of the things that you find is that they'll, the women especially, will say things that they think that you want to hear. And it has to do with their need to be accepted, which is related to the interpersonal dependency that we were just talking about. So, you know, you ask them, well, is there anything, you know, do you feel guilt? Well, of course they're going to say yes, because they want to have a positive appraisal from the person they're talking to. And you talk especially about a desire for mirroring of an image she attempts to maintain, and specifically as like a good mother. And you talk about how from the chart review, you've

find little interest in her children or their activities, no attempts to maintain contact with them. That's essentially like some of this lack of, it's not callousness, but it's like kind of a cold indifference. Is that what you're talking about? Yeah. Yep. And definitely, yeah.

They'll put out, especially in like group therapy, they'll put out, oh, I'm such a bad mom. I can't believe I did. this. And what what they're getting at, the other group members then will be like, no, you're a good mom. I see you doing this stuff. But that's not, it's just again, mirroring back. And they want from the psychologist, the therapist, the clinician. But they also like to get it from the other inmates as well. So, oh yeah, you are a good mom. You're doing the best you can. You're working on yourself to kind of boost again up this that, hey, maybe you're mirroring back this kind of good mother image or a good friend or wife or whatever it may be.

And I think also it's initially if that information isn't out there, they're not going to tell you that. That they're like a bad mother. Typically the story you get is that they're really a good mother. And they care deeply about their kids. And in some cases they'll even tell you that they talk to them all the time. Yeah. But when you look at the record review,

there's really no evidence of that. In some of these cases, they've had no phone calls with their kids. They've had no letters from kids. They've had no visits. Or to piggyback what you said, Ted, their charges against a sexual offense against their child, and they shouldn't be having any. It also goes back to that. I'm a good mom, but you're here for 30 years because you sexually assaulted your child.

yet they're prescuring themselves as a good mom and, you know, something bad, you know, going back to that. Well, yeah, I mean, that's a whole other issue is the sex offenders. Yeah. Because it's such a big delusional quality to those women. Mm-hmm. They will tell you things about how they're actually doing it to help their kids and they don't actually see it. A lot of them deep down don't actually see that there's a problem with it. Mm-hmm.

Yeah, I think that's something I looked at with. with a, we did an episode on pedophilia. And at times there's these cognitive distortions that they believe, which, um, just are not true, you know, like that the child wanted it or, you know,

like all these different things. Um, right. They're educating them. That's the big one. It's, you know, there's this kind of thought in my mind that it's very hard in one's mind

to think that I am not a good parent. And especially like, I'm thinking of a couple clients I've had who had heavy drug use early in life, and then they got sober and their kids won't talk to them because of how they were on methamphetamine and alcohol. And it's very hard for that person to grapple with this darker side of their reality. And what we're talking about to some degree is like... Especially women.

This like shadow aspect of our human nature that's capable of doing evil acts, you know, is it, it takes a certain level of psychological strength to be able to hold that in our mind, in our conscious mind, that we're capable of doing things that are not good. Yeah. Well, that's especially true of women, given these cultural ideas of motherhood and what a woman's supposed to be like and things of that nature. Okay. So it's important. formed by some degree by culture. Yeah.

And I think we'll get to another item, the parasitic kind of lifestyle that that one plays cultural aspects play big role in that one as well. Yeah, let's keep going. Item seven, shallow affect, unable to experience a wide range and depth of emotion. The emotions may be dramatic, shallow, and short-lived. Yeah, that goes back to kind of the pseudo-emotionality that we kind of talked about. For females, the labile kind of presentation of experiencing all these emotions in a short time kind of could get people confused that they may actually have a good range of emotions.

But then the shallowness, like when you actually go in there and ask them, you know, what is love or how did you know you were in love? And they give you the superficial thing. Like the person did a lot of things for me. So we must have been in love. So, you know, again, lack of depth into the. to the emotions. And I think you also have to be very mindful of tears that they will often cry,

but you have to kind of get an idea of why they're crying. One of the things that psychopaths are very good at, male and female, is getting people to project onto them. So typically a clinician, when they see somebody cry, they're projecting that the person is upset, that may not be actually the case that they're upset about what they've done. They might be upset about the fact that, you know, they feel criticized or things of that nature, that they feel sorry for themselves. Yeah. Yeah. You talk about narcissistic mirroring, and there's a quote by Nietzsche that you threw in there, which I just,

I just have to read this. I did that, says my memory. I did not, said my, says my, my, says my pride and memory yields. You know, it's this idea that like our minds play tricks on ourselves to maintain our ego strength or our like personhood, right? And so it's this idea that like we will believe lies about ourselves if it protects us psychologically, is that or protects this image of ourself that we ourselves want to believe about ourselves. Exactly it.

And then going a little further for the women, the narcissistic mirroring, this is what Carl and Ted found too, and their research was seeing children as extensions of themselves, using children as a way to kind of narcissistic kind of ways of looking and mirroring back, like not seeing them as their own entity children or things like that, but seeing them as as me and adding to some of that narcissistic kind of mirroring and we found that on the Roershack as well. You said look at the words guilt, remorse and look at the meanings of the words. Sometimes the words will mean different things for this type of person. Can you explain that?

Well, they normally can give like a textbook or dictionary kind of definition of it of guilt and remorse. So like, you know, I feel bad for things that I've done for guilt or, or they'll also kind of confuse remorse and guilt together. They'll be like, what's the, you know, have you ever felt remorse? Oh, yeah, I felt guilty before. Right. So kind of kind of fusing that. But then when they actually try to explain what they feel bad for or things like that,

they can't really give you a definition of it. So I think that's kind of going back to that, that shallow affect, not really feeling. something so much. We're still talking about the shallow affect. Yeah. And you say one more thing about the shallow affect, you said, look at attachments. Like if they said they were close to someone, did they put them on the visiting list? Yeah.

Have they visited in sent letters? Like, is there any depth to this sort of superficial, like, statement of attachments? Or even when they call home. So they do call home. For the 15 minutes or 20-minute phone call, are they always? ways just talking about themselves. Do they ask, hey, how's so-and-so doing or how's your health or things like that? It could just be one-sided that they just want to let them know. And then they, yeah, I talk to my mom every day, but all right, how's your mom doing? I don't know. That would

kind of be some of that kind of shallow affect and relationship stuff like that. Let's go item nine, parasitic lifestyle. So you talk about how women largely from historical records and third-party accounts, you can sort of see this parasitic lifestyle, receiving money from family or social assistance. You look at how the money is spent. You look at disability, benefits revoked, not paying child support. Anything you want to add about the difference between male and female parasitic lifestyle? Well, this one was kind of cultural, you know, the stay-at-home mom, for example, right? They could say that their stay-at-home mom, right? They didn't work. So we wouldn't score that if it was just stay-at-home mom as parasitic lifestyle. But when we go into, you were staying

at home as a mom, but she was getting high all day and not feeding or doing anything for the children, not taking care of things, then, okay, that would kind of be where some of the parasitic lifestyle, say the kid was on disability. Well, they would take the disability check, not buy food, but they would use it to buy drugs or stuff items for themselves, things like that. So, the cultural aspect kind of plays a role definitely in this item so you have to kind of tease out and if you don't go into depth that I would stay at home mom and then you just move on to the next item you might miss some of those those kind of behaviors let's jump to item 12 promiscuous sexual behavior so sexual relationships with others that are impersonal casual or trivial indiscriminate sexual partners you talked about how males endorse their promiscuity with pride.

Both of them describe sexual activity or deviant behavior with a sense of discomfort or reticence. I like to hear about that. It seems like the male would have less discomfort, but they do have discomfort? I think that the males have less. They'll give the number. Like, one of the questions, you know, we assess how many sexual partners would you have? males probably would be a lot easier to give that number. The reticence comes from the females.

Yeah. I had one example. I asked getting at sexual abuse, how many sexual partners, she had a low number, and I asked if you had any prostitution charges and no. And then using the style, Ted said at the end of the interview, said, you've been charged three times with prostitution. And she got like really anxious in her seat. she was moving around saying, no, that's not right, that's not right.

So again, the reticence to kind of talk about some of the sexual behaviors, you have to kind of take a more empathetic style to kind of elicit that data. I think the males tend to talk about with a sense of pride, whereas the women don't, that they actually view it as being criticized. And also on the prostitution aspect, You have to be careful about that one. And in terms of clearly looking at it, because, you know, some women have been trafficked.

Some women have been, you know, hooked on drugs, et cetera, gotten victimized by pimps, things of that nature. So anytime I have a prostitution background and if somebody I'm evaluating, I want to get a sense of what that was like for them. versus, you know, like if some of them actually say that they were into it because they liked it. Now that would be somebody that would be a two on that, that they, you know, they like going to swing parties. They liked, you know, performing sex in front of people, getting paid for it versus somebody that is obviously traumatized and victimized by the experience that you want to be careful about that. Okay. Item 12, early behavioral problems, serious behavioral problems as a child, persistent lying, cheating, theft, robbery, fire setting, disruption of classroom activities, violence, bullying, running away from home. You talked about how there's often a diffusion of responsibility or rationalization of these behaviors.

Is that the main sort of characteristic of females, or is there, did you see that in both? females too also with kind of diffusion getting kind of back to the kind of the trauma and stuff like that that they may say you know my parents were the reason why I acted out and things like that it's a possible that that could be kind of a difference I think in general too I think the data kind of shows less for the females less kind of juvenile kind of behaviors not necessarily might not be more gossiping or more kind of things that aren't as overt for the male, male psychopaths as they grow older, right? They are more likely maybe to do the fire setting or abusing the animals, things like that.

The females might not have that, but more ostracizing, more gossiping, things like that, which may not kind of show up as much in the records for female younger in age than the males. And I think it also relates to how they tend to commit their offenses with other people. So a female psychopath will be typically hook up with either a male, violent male or a stronger violent woman in order to have their crimes because they may not have the actual physical prowess to dominate others. Okay, so getting to the end of our... our time here. I'm wondering if we should do a part two. There's so many things I wanted to get to.

I feel like we just barely scratched the service. But maybe that's good, you know, because maybe someone will be interested in diving into this deeper and learning about the Rochok and how that relates. And there's a lot I wanted to learn about that. And also, you get into management, treatment, and some just good stuff there. Any final remarks, things that you would want people to have a takeaway from this discussion and from your book in general? For me is just understanding that female offenders and female psychopaths are present differently than the males. So trying to understand, especially if you're interacting with this population female offenders,

is to kind of change your conceptualization of what female psychopathy is and that it's different than male psychopaths would be my takeaway. And I feel we do a really good job in the book explaining all that. Yeah. I think I would agree with what Jason said, but I think I would add to it the element of bias that comes into this, that this is a population in which there's a great deal of bias, that if you just do a search on female offenders,

you'll find just volumes and volumes of material about how they've been victimized by the legal justice system, etc. And in our review of the literature, we didn't actually find that, that there was actually more data, just actual data to suggest that they had been less severely treated than the men. And I've seen that myself as a forensic psychologist, that things that, you know, a woman would be, sent to a program, be given all kinds of services. If it's a male, they're much more likely to be incarcerated, especially African-American males, the most likely to be incarcerated out of all of the different demographics within a forensic population.

So I think that would be a big, just to add on what Jason said, to add to that would be that, you know, just go by the data, not by the cultural bias. Yeah, and I appreciate you guys coming on, giving your wisdom. It's been fun for me to learn more about this. Fun and also, I don't know, there's an aspect of like, you know, I'm not a forensic psychologist or psychiatrist. I would probably be a horrible one, actually,

because I would be siding with, I'd want to believe them and support them. and, you know, I would be like wanting to give them empathy where I'd probably kind of be falling into their traps for their desire, for their image to be maintained, you know. So I think it's good for someone like myself to have some knowledge of this, you know, to not be naive. And I hope that my listeners enjoy this conversation as well. I think your publisher who reached out to me will give us a discount code. So I'll put that in the resource library. I'll put that discount code on the PDF that goes with this episode. So if you want to go to my resource library, psychiatrypodcast.com.

And I don't think either of you have conflicts of interest other than selling a book, but you're not selling the book to patients, so it's not really the conflict of interest that we're looking at. So no conflicts of interest here. I'm not being paid by them or their publishers, so no conflicts of interest there. And as always, you know, I prize having no conflicts of interest, just pure learning, pure growth, wisdom, empathy for our patients.

So, yeah, thanks so much for coming on, and we'll leave it there. Thank you very much. We really appreciated it. Yeah, I really appreciate it as well. And thank you for the interest. And if there's an interest in another one, we'd love to do that. I would be interested. Yeah.