Conceptualization of hostile psychopathy and sadism: Drive theory and object relations perspectives

A distinct formulation of hostile psychopathy is presented, based on analytic clinical experience with psychopathic youth and adults. Two psychodynamic conceptualizations of aggression are presented - one connoting a basic destructive drive, the other portraying aggression as a means of ensuring gratification and countering frustration. Following Meloy's (1988) analysis of psychopathy as a combination of a deficient object relational capacity to bond and high levels of instinctual aggression, hostile psychopathy in general, and sadism specifically, are conceptualized from these two perspectives. Sadism, which features re-enacted events of violence, is posited as a distinct manifestation of hostile psychopathy with ritualized features attributable to object relations disturbances. Other variants of hostile psychopathy are analyzed as derivatives of more direct aggressive instinctual expressions that are not relational in their intent or function, in which destructiveness is an end in itself. Hostile psychopathy is presented as entailing elements of an instinctual propensity toward aggressive discharge. In addition, a more elaborate motif is posited in which the pain and suffering of others is the key factor in sadism. In the latter facet, there is an actual enjoyment of the others' suffering, and unresolved relationships are re-enacted with a reparative intent. A psychosexual developmental hypothesis is suggested, in which drive-based aggressive discharge is linked to the oral sadistic stage, while sadistic relational dynamics are posited to reflect the power-control battles of the anal sadistic stage. As a limitation, it is noted that the sociopolitical aspects of psychopathy are not addressed in this clinical analysis. Moreover, since the data presented are oriented toward the intrapsychic (in contrast to social) aspects of psychopathy, the countertransference aspects of relationships that psychopaths tend to engender are not addressed specifically.