Are Psychopaths Psychotic?

I have seen countless occurrences on social media where people conflate psychopathy with psychotic symptoms.  I’m amused when arguments break out referring to whether ‘psycho’ is a slur, and if so, can it be reclaimed by psychopaths or psychotic individuals or neither.  Let me state unequivocally that psychopathy and psychotic symptoms are not the same.  Are psychopaths psychotic?  Maybe some are, but the definition of psychopathy does not require any break from reality or delusion.

Psychopathy refers to a nuanced disorder in which a combination of antisocial aspects and emotional poverty are present.  Psychotic refers to breaks from reality or extreme delusion.  It should be self-evident that these two conditions are not the same.  Psychopaths, generally, know what they are doing at all times.  They are acutely aware of the reality of their surroundings, and the only delusions held by psychopaths are usually with respect to themselves and their goals.

Now all of that said, the psychotic psychopath is an individual that even I would not want to be around.  It would not surprise me – though I am unwilling to do the research – that some serial killers fall into this category.  An individual that lacks remorse, affective empathy, conscious, and a firm grip on reality would not be one of society’s doers but rather one of society’s reapers.

Are psychopaths psychotic?  The overwhelming majority are not.  Psychopaths, by and large, are fully aware of what they do and what surrounds them; they simply do not care about the consequences for those individuals caught in their vortex.  Psychotic individuals may not be aware of their own actions or surroundings and do care to regain a level of morally-acceptable sanity.  Individuals confusing these two terms need to do additional research to straighten their beliefs out as the conflation of the two terms disrespects those falling into either group.

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  1. NT says

    As far as I know, psychopaths are do not dissociate, which is what psychosis is all about; losing one’s grip with reality. Psychopaths are the ultimate realists.

    • Anonymous says

      Ultimate realists? Really? Ever had a discussion with one about their parasitic behaviour and remorseless manipulation of another’s good will? Reality breaks down as denial escalates.

      Only way out is to walk away.

      • NT says

        You misunderstand me. They are the ultimate perceivers of reality (i.e. they have the best perspective of what’s going on around them). But they are also the best at eroding OTHER people’s realities. And yes, I have. I work for three of them. (Well, one of them I forced to resign, the other two I’m marking for termination.)

  2. FNP says

    Narcissistic delusions are not breaks from reality. They’re simply enhanced reality. You cannot be stuffed in the loony bin for being narcissistic (which all psychopaths are).

    Psychotic people, on the other hand, can’t function while having a psychotic episode.

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