Bonding over bullying

I've been meaning to post about this Invisibilia episode for ages, and also saw this comment from a somewhat recent post that made me want to post it again, and finally have gotten around to it.

So the Invisibilia episode is worth listening to fully, at least the first half of it. It talks about a woman who has always been treated badly, bullied, and even villified, and she had no idea why. She's high functioning -- a doctor -- but she found social interactions to be very difficult. She describes the worst of many similar episodes of bullying:

The worst thing that ever happened was, I was at summer camp, and I don't know what I did. I have no idea. But they actually bound and gagged me and took me out of the cabin at night in the rain and put me outside, and it was just awful.

Here's why: "Kim's brain is not great at seeing emotion. When she looks out at the world, she physically sees all the things that most people see. It's just that much of the emotion is subtracted. Though for most of her life, she didn't realize that, and so her interactions with other kids could be difficult."

She undergoes TMS, transcranial magnetic stimulation, which some of you may remember from Wisdom of Psychopaths: "Basically in TMS you take this very fancy magnet, hold it to the scalp and send pulses through the skull to get brain cells to activate in a different way. They typically change for a very short period of time - between 15 and 40 minutes."

During TMS, she experiences for the first time an awareness of the emotional world, and realizes that this whole time she has been missing out on millions of emotional cues from the people around her. She says that she would have otherwise had no idea that such a world existed before, because she had always just believed that the way she saw the world was the way the world actually was (sound familiar to all of you out there?).

I thought the hosts had an interesting reaction to her realization that the world was different than she thought it was -- as if maybe she would have been better off not knowing. But she doesn't see it that way at all:

But even though TMS has not changed Kim's ability to see long-term, she says she's still happy she got it. She says she thinks a lot about one of the videos she was shown. In it, two employees were saying mean things to a fellow employee named Frank. And Kim says the first time she watched it before the TMS, she couldn't answer any of the questions the researchers were asking about it. But afterwards, she understood not only the video but also one of the big mysteries that had dominated much of her life.

KIM: It never made any sense to me as to why people would be mean to somebody else. Why would you be mean to somebody? And what I saw is that when the two employees were there and were talking together and then were giving Frank a hard time, the primary thing was not that they were trying to be mean to Frank.

The primary thing is that they were bonding, building a bond between the two of them. And it was simply the means to do it was to be nasty to Frank. And then I was like, oh, maybe that's what these kids were doing when they were bullying me.

SPIEGEL: It's much easier to live in a world which makes sense, where people are mean not just for fun but because they, like everyone else, want to belong and feel safe. Now that's the world that Kim lives in. 

This same phenomenon of bonding over bullying was referenced in the comment I mentioned above:

But I also made the experience, that the team spirit in a group is rising if there is a common "enemy/victim". Well it's at the victims expense but for the rest of the group and their friendships it is something positive... Anyway, I don't know if this phenomenon is also visible in a group consisting of various sociopaths.

The point of the podcast was that everyone has blindspots -- everyone has a certain viewpoint that by its very nature is limited. As much as Kim was blind to emotions and sociopaths are blind to morality, empaths are also blind to the random things they get up to -- like bonding over bullying. The key is to have just a little bit of intellectual humility to admit the possibility that the way you see the world may not be 100% accurate. 

Neurofeedback

I have been putting off writing about this because I wish that I knew more and could tell you more, but I also feel like better something than nothing. This past summer I did a round of 15 sessions of neurofeedback along with a friend who really wanted to try it and wanted sort of a buddy in the process, but also because I have always struggled to fall asleep and stay asleep and this was recommended to me as a potential help. I don't really want to try to describe the process completely or even my experience with it (nor give the impression that I endorse it) but I do want to relate a little of my experience with it.

I first started with a QEEG mapping of my brain, essentially (and forgive my ignorance) where they put a cap on your head are tracking your brain waives with all of these nodes placed in different areas of the scalp. This UCLA professor kind of describes its use in neurofeedback here. One thing that I found incredibly credible about the results was that knowing nothing about me (I never told him about my diagnoses of anything), my practitioner told me, in this very cautious way, "I don't want to alarm you or anything, and this is definitely something that we can see in the "normal" population but it is much more common in the autism spectrum, but your empathy and emotional processing regions have abnormally low functioning. Do you ever feel like you are disconnected from your emotions or other people?"

So even though my primary focus was on sleep, brain efficiency, and perhaps increased creativity (if any of these were possible and I was just making a wishlist), my practitioner became pretty fixated on working on the emotional processing. Sometimes he wouldn't tell me outright that was what he was doing for that particular session, I could just tell from the types of questions he would ask me. Sometimes he told me but said that he thought it was necessary to get that up and running before we targeted other things on my wishlist.

Things I appreciated about the experience:

1. It was a little validating to hear that my brain actually is demonstrably mapped out to be crapped out (at least according to these metrics) when it comes to empathy. 
2. Making the little green boat move with my brain waves while keeping the red and yellow boats still in the little electronic regatta made me realize: (1) my thought patterns are a lot more fixed and beyond my control than I realize and (2) because I consciously process so much information as it comes into my brain, I am less open minded. By the latter I mean that my very mechanism of trying to consciously process as much information as I can rather than letting the subconscious deal with it requires me to quickly categorize the data as being interesting or important or not, and always according to my pre-existing criteria. I've always thought that this made me function higher cognitively because less is getting past me, but I realized that it also has the weird but predictable effect of making me search for familiar patterns and thus be closed minded to truly new things, concepts, or types of information. 
3. Certain sessions (again forgive my ignorance) where he wasn't tracking my brain waves but feeding my brain certain waves could be an absolute trip. Once I felt for all the world like I was on an opiate.
4. I slept really soundly and deeply after almost every session in what felt like deep, restorative sleep. 
5. I did sometimes feel waves of affection or other very strong emotional moments of truth, either during the sessions or in the days between the sessions, that suggested that there is still (for me) a capacity for less muted emotions. 

I didn't continue after 15 sessions because my talk therapist suggested that the problem with the neurofeedback technology and techniques are that the brain changes are there, but that they don't last. Again, I did not do any research to verify that claim, so forgive my ignorance.

Even if the effects did not last, there were certain realizations I made during the process that have lasted. I understand better how my brain takes in raw information and that my most efficient brain processing is not to try to earmark or categorize everything as it is coming in (as I naturally default too now), but rather to try to passively let the information come to me in whatever form it chooses to take -- as if there is a direct tunnel of information from the source straight to my brain and I just need to keep that tunnel clear, not force anything. I realized that I do have strong attachments to my loved ones, even if that feeling of attachment or love does not always seem very accessible to me. My practitioner was also a dabbler in dream interpretations, and I learned that whether or not dreams actually have meaning, there was sometimes useful information to glean from the analysis of my dreams. Maybe I will discuss one particularly clear example in a future post. 

Right brained (part 1)

This is a somewhat old study done by ex-USC research Adrian Raine that suggests that the difference between high functioning "successful" sociopaths and low functioning "unsuccessful" sociopaths might actually be neurological:

He tested the theory that psychopaths with hippocampal impairments could become insensitive to cues that predicted punishment and capture. As a result, he said, these “impaired’ psychopaths were more likely to be apprehended than psychopaths without that deficit.

Fewer than half of both the control subjects and the “successful” psychopaths had an asymmetrical hippocampus.

Ninety-four percent of the unsuccessful psychopaths had that same abnormality, with the right side of the hippocampus larger than the left.

Raine said the results suggest, but don’t prove, a neuro-developmental root for psychopathy.

In a second study, he looked at the corpus callosum of both types of sociopaths, and found that they are both longer and thinner than that of the average neurotypical:

The corpus callosum is a bundle of nerve fibers that connects the two hemispheres of the brain, enabling them to work together to process information and regulate autonomic function. Raine explored its role in psychopathy for the first time.
“There’s faulty wiring going on in psychopaths. They’re wired differently than other people,” Raine said. “In a way, it’s literally true in this case.”

He found that the psychopaths’ corpus callosums were an average of 23 percent larger and 7 percent longer than the control groups’.

“The corpus callosum is bigger, but it’s also thinner. That suggests that it developed abnormally,” Raine said.

The rate that the psychopaths transmitted information from one hemisphere to the other through the corpus callosum also was abnormally high, Raine said.

Of course they don't credit the sociopath brain as having an advantage over a neurotypical brain, despite the demonstrated greater efficiency in transmitting information between brain hemispheres. Instead this efficiency is vaguely insinuated as the cause for the sociopath's "less remorse, fewer emotions and less social connectedness - the classic hallmarks of a psychopath."

Normal people, even scientists, won't ever admit that a sociopath's brain might actually be better. Every single article I have seen that even comes close to discussing some of the advantages of the sociopathic brain eventually backs off and makes some pat conclusion about how broken we are. In fact, the title of the article is "Out of Order." But there are two meanings to that phrase, and I think only one of them applies to this sort of bias thinly masked as science.

James Fallon's Life as a Nonviolent Psychopath

I've been meaning to do a post on the Atlantic's interview with James Fallon (Life as a Nonviolent Psychopath) about his new book, "The Psychopath Inside: A Neuroscientist's Personal Journey into the Dark Side of the Brain." Both the book and the article are worth reading in their entirety.

My favorite part in the article was Professor Fallon describing his relationship with his close associates, wife and sister:

I started with simple things of how I interact with my wife, my sister, and my mother. Even though they’ve always been close to me, I don't treat them all that well. I treat strangers pretty well—really well, and people tend to like me when they meet me—but I treat my family the same way, like they're just somebody at a bar. I treat them well, but I don't treat them in a special way. That’s the big problem.

I asked them this—it's not something a person will tell you spontaneously—but they said, "I give you everything. I give you all this love and you really don’t give it back." They all said it, and that sure bothered me. So I wanted to see if I could change. I don't believe it, but I'm going to try.

In order to do that, every time I started to do something, I had to think about it, look at it, and go: No. Don’t do the selfish thing or the self-serving thing. Step-by-step, that's what I’ve been doing for about a year and a half and they all like it. Their basic response is: We know you don’t really mean it, but we still like it.

I told them, "You’ve got to be kidding me. You accept this? It’s phony!" And they said, "No, it’s okay. If you treat people better it means you care enough to try." It blew me away then and still blows me away now. 

My second favorite part was on the possibility of change:

I think people can change if they devote their whole life to the one thing and stop all the other parts of their life, but that's what people can't do. You can have behavioral plasticity and maybe change behavior with parallel brain circuitry, but the number of times this happens is really rare.

Interestingly, I've felt like with my life being somewhat ruined by publishing the book, I have plenty of time now to do this very thing. I'm curious where it will take me.

Other topics include how sociopaths have a Zen Buddhist perspective, the difference between someone who becomes a violent sociopath and someone who does not, how and why treatment of infants and small children is critical to their development, and why sociopathic traits might not really "mature" until the adult brain has matured.

James Fallon: The Psychopath Inside Q&A

Professor James Fallon has written an exciting new book combining his background in neuroscience with his personal experience having many characteristics (and the brain scan) of a psychopath. THE PSYCHOPATH INSIDE: A Neuroscientist’s Personal Journey into the Dark Side of the Brain (Kindle version here) is part memoir and part scientific review of both the recent genetic and neuroscience research that has been done on psychopaths.

As a special offer to this blog's audience, Dr. Fallon has graciously offered to answer some of your questions. If you have a question for Dr. Fallon, please post it in the comments addressed to "Dr. Fallon:". I will collect your questions (or a representative sample) and send them to him. When I receive his answers, I will post them in a future blog post.

Here is an except from his book:

I was thinking about putting something up about the book and then asking my readers and twitter followers if they had any questions in particular that they would like to ask him. I could select a representative sample, if he would be willing to give his thoughts? 

One October day in 2005, as the last vestiges of an Indian summer moved across Southern California, I was inputting some last-minute changes into a paper I was planning to submit to the Ohio State Journal of Criminal Law. I had titled it “Neuroanatomical Background to Understanding the Brain of a Young Psychopath” and based it on a long series of analyses I had performed, on and off for a decade, of individual brain scans of psychopathic murderers. These are some of the baddest dudes you can imagine—they’d done some heinous things over the years, things that would make you cringe if I didn’t have to adhere to confidentiality agreements and could tell you about them. 

But their pasts weren’t the only things that separated them from the rest of us. As a neuroscientist well into the fourth decade of my career, I’d looked at a lot of brain scans over the years, and these had been different. The brains belonging to these killers shared a rare and alarming pattern of low brain function in certain parts of the frontal and temporal lobes—areas commonly associated with self-control and empathy. This makes sense for those with a history of inhuman violence, since the reduction of activity in these regions suggests a lack of a normal sense of moral reasoning and of the ability to inhibit their impulses. I explained this pattern in my paper, submitted it for publication, and turned my attention to the next project. 

At the same time I’d been studying the murderers’ scans, my lab had been conducting a separate study exploring which genes, if any, are linked to Alzheimer’s disease. As part of our research, my colleagues and I had run genetic tests and taken brain scans of several Alzheimer’s patients as well as several members of my family, who were serving as the normal, control group. 

On this same October day, I sat down to analyze my family’s scans and noticed that the last scan in the pile was strikingly odd. In fact it looked exactly like the most abnormal of the scans I had just been writing about, suggesting that the poor individual it belonged to was a psychopath— or at least shared an uncomfortable amount of traits with one. Not suspicious of any of my family members, I naturally assumed that their scans had somehow been mixed with the other pile on the table. I generally have a lot of research going on at one time, and even though I try to keep my work organized it was entirely possible for things to get mixed up. Unfortunately, since we were trying to keep the scans anonymous, we’d coded them to hide the names of the individuals they belonged to. To be sure I hadn’t mixed anything up, I asked our lab technician to break the blind code. 

When I found out who the scan belonged to, I had to believe there was a mistake. In a fit of pique, I asked the technician to check the scanner and all the notes from the other imaging and database technicians. 

But there had been no mistake. 

The scan was mine.

Reprinted from THE PSYCHOPATH INSIDE: A Neuroscientist’s Personal Journey into the Dark Side of the Brain by James Fallon with permission of Current, a member of Penguin Group (USA) LLC, A Penguin Random House Company. Copyright (c) James Fallon, 2013.

Failure to conform to social norms

One of the primary characteristics of a sociopath is a failure to conform to social norms. Interestingly, this appears to be linked to a particular part of the brain and such that activity in that segment predicts whether and how someone will conform to social norms. From Science Daily:

"We discovered that the decision to follow the fairness norm, whether voluntarily or under threat of sanctions, can be directly influenced by neural stimulation in the prefrontal cortex."

Researchers asked the participants to participate in a classic sharing game:

"[T]hey received money and were asked to decide how much of it they wanted to share with an anonymous partner. A prevalent fairness norm in Western cultures dictates that the money should be evenly split between the two players. However, this contrasts with the participants’ self-interest to keep as much money as possible for themselves. In another experiment, the participants were faced with the same decision, but knew in advance that they could be punished by the partner for an unfair proposal."

Stimulating the right prefrontal cortex changed people's willingness to conform to social norms, but in odd, and seemingly contradictory ways depending on whether there was a threat of punishment:

When neural activity in this part of the brain was increased via stimulation, the participants’ followed the fairness norm more strongly when sanctions were threatened, but their voluntary norm compliance in the absence of possible punishments decreased. Conversely, when the scientists decreased neural activity, participants followed the fairness norm more strongly on a voluntary basis, but complied less with the norm when sanctions were threatened. 

But is that because people's perception of the fairness of the game shifts as well? In short, no:

Moreover, neural stimulation influenced the participants’ behavior, but it did not affect their perception of the fairness norm. It also did not alter their expectations about whether and how much they would be punished for violating the norm.

What does this suggest? Researchers concluded that it is quite possible to know something is wrong, but be more or less likely to conform your behavior to that knowledge based on brain activity:

We found that the brain mechanism responsible for compliance with social norms is separate from the processes that represent one’s knowledge and beliefs about the social norm," says Ernst Fehr, Chairman of the Department of Economics at the University of Zurich. "This could have important implications for the legal system as the ability to distinguish between right and wrong may not be sufficient for the ability to comply with social norms." Christian Ruff adds: "Our findings show that a socially and evolutionarily important aspect of human behavior depends on a specific neural mechanism that can be both up- and down-regulated with brain stimulation."

This was a particularly interesting finding to me because sometimes I have felt like the reason I do wrong things is not because I don't know that they are wrong, but that I don't recognize in that moment that they are or I don't care about the particular consequences, i.e. no threat of punishment. I feel like I respond really well to incentives. If there is a very clear consequence I actually care about (e.g. the certainty of a dismemberment or the possibility of something good), my behavior will naturally maximize that incentive structure. It makes me wonder, if there are people like me who respond best to material consequences (high activity in this part of the brain?), are there people who respond best to just the thought of fairness and being a good person (low activity in this part of the brain?). Either way, I really like the point made at the end about the legal definitions of insanity not just for psychopaths, but for other disorders characterized by a failure to conform to social norms like Asperger's and others on the autism spectrum.

The psychopath problem

The psychology world seems to be taking a fresh look at sociopathy. Apparently once people dared question the infallibility of Hare's diagnostic criteria, the Psychopathy Check List Revised ("PCL-R"), it opened the door for other heresies against established views.

In his new book "Forensic Psychology: A Very Short Introduction," David Canter, a psychology professor at the University of Hudderfield, briefly describes the psychopath problem:

Until you have met someone whom you know has committed horrific violent crimes but can be charming and helpful, it is difficult to believe in the Hollywood stereotype of the psychopath. Without doubt, there are people who can seem pleasant and plausible in one situation but can quickly turn to viciousness. There are also people who just never connect with others and are constantly, from an early age, at war with those with whom they come into contact. If we need a label for these people, we can distinguish them as type 1 and type 2 psychopaths. The former have superficial charm, are pathological liars, being callous and manipulative. The clearest fictional example of this sort of psychopath is Tom Ripley, who has the central role in many of Patricia Highsmith’s amoral novels. The type 2 psychopaths are more obviously criminal, impulsive, and irresponsible with a history of juvenile delinquency and early behavioural problems.

Another label that may be assigned to people who are habitually involved in illegal, reckless, and remorseless activities that has a much broader net than ‘psychopathy’ is ‘antisocial personality disorder’. But we should not be seduced into thinking that these diagnoses are anything other than summary descriptions of the people in question. They do not help us to understand the causes of people behaving in these unacceptable ways. Some experts have even commented that they are actually moral judgements masquerading as medical explanations. So although the labels ‘personality disorder’ and ‘psychopath’ do summarize useful descriptions of some rather difficult, and often nasty, people, we need to look elsewhere for explanations of how they come to be like that.

The psychopath problem for society is "how do we keep psychopaths from acting in antisocial ways?" The psychopath problem for psychologists is "what are we really dealing with here?" Before psychologists can even begin understanding psychopaths, they must be able to identify them. Before psychologists can identify psychopaths, they must be able to understand them. It's a classic chicken/egg dilemma that leads critics like our favorite narcissist Sam Vaknin to quip that "psychopathy seems to be merely what the PCL-R measures!" and probably led the good folks putting together the DSM to eventually exclude psychopathy as a diagnosis in favor of the more criminal-sentencing friendly ASPD.

Still, these tests are being used, and brains of people flagged by these tests are being scanned and studied, helping scientists to learn more about . . . the brains of people who would be flagged by these tests. Some of the new discoveries or theories about psychopathy jive with my own personal experiences, and some of them strike me as being less than accurate -- an attempt to add an epicycle to support some of the weaker premises that provide the basis for the modern study of psychopathy. Maybe it is true that we are on the verge of a breakthrough, as some psychologists think -- a unifying theory of the causes and explanations for psychopathic behavior. If we are, I think it will have to be a product of fresh thinking, rather than continuing to focus on the same "20 items designed to rate symptoms which are common among psychopaths in forensic populations (such as prison inmates or child molesters)."

Junk science

I often see sociopath research that by itself is not dubious, but the implications or the conclusions that the researchers draw from the evidence seems stretched, non sequitur, or wholly unsupported by the data. For instance, I wrote about research suggesting that the sociopath's corpus callosum is longer and thinner than the average person's brain, resulting in a faster rate of transfer of information between the two hemispheres of their brain. Rather than cite this as a possible advantage of the sociopath brain, researchers conjectured that this might explain why sociopaths have "less remorse, fewer emotions and less social connectedness." What? Maybe it's just my lack of understanding, but that conclusion doesn't seem to follow at all from the fact that sociopaths have a more efficient corpus callosum.

Sometimes the problem with the research or logic is the complete circularity of the research -- i.e. the tautology of the assertion people who manifest antisocial traits tend to behave antisocially. For instance, a new study found out that people who self-report that "what matters for me is the bottom line,"will behave more ruthlessly and selfishly in prisoner's dilemma style games:

The study involved normal undergraduate students around age 19. The students were divided into small groups and told to converse on a topic of their choice for 10 minutes. Then, they were separated and given a questionnaire to measure their psychopathic tendencies. The questionnaire asked them to rate their agreement with statements, such as"what matters for me is the bottom line," or "I am often angry in social situations." There are two kinds of psychopathy, but this study was looking at the classic "conniving and cold" psychopaths.

Next, the researchers had the students play a "prisoner's dilemma" game, in which each person was given a sum of money that they could keep for themselves or transfer to a partner, for whom it would be doubled. For example, both people would start with $3; they could either keep $3 or give $6 to their partner. If the game has several iterations, it is in both people's best interest to cooperate and give the money away, because both will receive $6 instead of $3. But if it's just a one-shot game, it's in a person's best interest to keep the $3 for himself or herself, as there can be no consequence of not cooperating. (This experiment involved a one-shot game, though participants weren't told that fact.)

The students who scored higher on the questionnaire (meaning they were more psychopathic) were more likely to betray their partner and keep the money for themselves if that partner interrupted them more frequently (a sign of disrespect). The more psychopathic students were also more likely to betray a partner with whom they appeared to have less in common, and were therefore less likely to see again. In other words, those with more psychopathic tendencies only cooperated if there was something in it for them.

The conclusion:

"Traits such as deceitfulness and conceitedness — as opposed to honesty and humility — involve a willingness to take advantage of others when the opportunity arises."

Hm.

Borderline personality disorder vs. sociopathy

This was an interesting article from the Psychology Today blog relating an experiment done examining the brain activity of sociopaths and comparing it to that of people with borderline personality disorder. Why these two disorders? Apparently, sociopathic and borderline traits occur with equal frequency among violent offenders, but they reach their antisocial behavior in different ways:

Typically, antisocial offenders with borderline personality disorder are emotionally reactive, unable to regulate emotions, bereft of cognitive empathy (knowing how another person feels), rageful, and reactively aggressive. By contrast, antisocial offenders with high psychopathic traits can be characterized as emotionally detached, cognitively empathic, morally problematic, exploitative, and proactively and reactively aggressive.

The experiment:

The investigators took MRI scans of the two groups of antisocial offenders, with the aim of exploring differences in the cerebral structure of their brains. All offenders had been convicted for capital, violent crimes (including severe bodily injury such as murder, manslaughter, robbery, or rape) from high-security forensic facilities and penal institutions and were formally diagnosed with antisocial personality disorder. There was also a comparison group of healthy men.

The results:

The antisocial offenders with borderline personality disorder had alterations in the orbitofrontal and ventromedial prefrontal cortex regions, which are involved in emotion regulation and reactive aggression; there were also differences in the temporal pole, which is involved in the interpretation of other peoples’ motives. By contrast, the antisocial offenders with high psychopathic traits showed reduced volume mostly in midline cortical areas, which are involved in the processing of self-referential information and self reflection (i.e., dorsomedial prefrontal cortex, posterior cingulate/precuneus) and recognizing emotions of others (postcentral gyrus). 

I thought this was interesting. I wrote previously about the connection between sociopathy and alexithymia, or the decreased ability to identify, understand, and describe one's own emotions. This trait has been linked to a lack of empathy, the idea being that if you are unable to understand your own emotions, you don't stand much of a chance of understanding the emotional worlds of others. I feel like I don't understand my emotions, that they feel out of context to me, like I'm getting only snippets of a movie played backwards. This feeling probably contributes to my weak sense of self. This brain scan study seems to comport with this theory -- that sociopaths suffer from an ability to process self-referential information and to self-reflect, and that consequently sociopaths have flexible understandings of not only morality, but basically every human trait.

Psychopath: the documentary

This hour long documentary is probably worth watching, particularly for people who are just learning about sociopathy. For the sociopaths, most of it will seem a little over the top, but for some reason that passes as science and journalism when it comes to the dreaded sociopath.

Interesting moments:

27:42 What sociopaths are doing/thinking when they are talking to you.

31:14 Nature vs. nurture -- environment alone isn't enough to create a sociopath, otherwise we'd see more sociopaths in war torn areas, also "intervening" with child sociopaths.

34:40 Biological basis for the condition.

42:40 Treatment.

45:05 Mandatory brain chips and/or "surgical intervention" for sociopaths.

Microchips in the brain is by far the scariest idea I have even heard of to "deal" with the "psychopath problem," and I have heard of a lot of creative ones involving islands, internment camps, or specialized soldiers. My favorite comment:

“we will replace ‘dysfunctional’ brain mechanisms with microchips” what the…!?!?!?!!! no you wont, i’ll quite happily be labelled as psychotic for violently opposing such an idea! ultimate mind control! ill be thankful for some violent psychopaths when the powers that be try that one!!!! The moral authority of these guys is terrifying to say the least it absolves them as ‘normal’ people, my definition of psychopath would include anyone who thinks mind control chips are an acceptable course of action! microchip control for difficult people who dont fit into a society that worships money and rewards the ‘industrial psychopaths’ with untold riches. i wonder if we are all a little bit psychotic and these therapists are the abnormal ones in trying to standardise emotional response to life events- prescribing that any given situation has a ‘proper’ emotionally standard response? the guy who describes the psychopaths abnormality as reading someone else’s faces and tailoring what they say in response- like this is some sort of weird anomaly. pathologically frightened control freaks are what the therapists come across as by their own diagnostic criteria, desperately seeking to reign in the personalities they cannot understand. i’ve watched some scary documentaries by alex jones et al about social control but this one is far more frightening in its implications. eugenics is alive and well, cull the abnormal, praise be to the sheepthinkers.

Can we eliminate evil?

A reader suggested this Morgan Freeman narrated special "Through the Wormhole: Can We Eliminate Evil?" Not surprisingly, it features sociopaths and studies on the brain that give interesting insight to how we decide what to do and what constitutes evil.

The first clip is about empathy, and illustrates well the recent study that found that sociopaths feel empathy when directed to put themselves in the shoes of others.




If you have the genetics of a killer and the brain anatomy of a killer, are you destined to become a killer? James Fallon.




And finally this was an illustration of this experiment regarding the moral lives of babies.

Criminal sentencing for sociopaths

The role that a diagnosis of psychopathy should play in criminal sentencing is an admittedly thorny issue. The legal standard for an insanity plea is that the perpetrator must not be able to distinguish between right and wrong. Sociopaths actually know the difference between right and wrong most of the time, they just don't care (enough to conform their behavior to societal standards). The debate is whether this faulty wiring makes them more culpable, less culpable, or equally culpable to a similarly offending non-sociopath. A prominent researcher who specializes in scanning the brains of sociopaths in prisons, Kent Kiehl, suggests in an interview with NPR that we should cut them some slack:

Brian Dugan . . . is serving two life sentences for rape and murder in Chicago. Last July, Dugan pleaded guilty to raping and murdering 10-year-old Jeanine Nicarico in 1983, and he was put on trial to determine whether he should be executed. Kiehl was hired by the defense to do a psychiatric evaluation.

In a videotaped interview with Kiehl, Dugan describes how he only meant to rob the Nicaricos' home. But then he saw the little girl inside.

"She came to the door and ... I clicked," Dugan says in a flat, emotionless voice. "I turned into Mr. Hyde from Dr. Jekyll."
***
"And I have empathy, too — but it's like it just stops," he says. "I mean, I start to feel, but something just blocks it. I don't know what it is."

Kiehl says he's heard all this before: All psychopaths claim they feel terrible about their crimes for the benefit of the parole board.

"But then you ask them, 'What do you mean, you feel really bad?' And Brian will look at you and go, 'What do you mean, what does it mean?' They look at you like, 'Can you give me some help? A hint? Can I call a friend?' They have no way of really getting at that at all," Kiehl says.

Kiehl says the reason people like Dugan cannot access their emotions is that their physical brains are different. And he believes he has the brain scans to prove it.
***
Psychopaths' brains behave differently from that of a nonpsychopathic person. When a normal person sees a morally objectionable photo, his limbic system lights up. This is what Kiehl calls the "emotional circuit," involving the orbital cortex above the eyes and the amygdala deep in the brain. But Kiehl says when psychopaths like Dugan see the KKK picture, their emotional circuit does not engage in the same way.
***
Kiehl says the emotional circuit may be what stops a person from breaking into that house or killing that girl. But in psychopaths like Dugan, the brakes don't work. Kiehl says psychopaths are a little like people with very low IQs who are not fully responsible for their actions. The courts treat people with low IQs differently. For example, they can't get the death penalty.

"What if I told you that a psychopath has an emotional IQ that's like a 5-year-old?" Kiehl asks. "Well, if that was the case, we'd make the same argument for individuals with low emotional IQ — that maybe they're not as deserving of punishment, not as deserving of culpability, etc."
***
This argument troubles Steven Erickson, a forensic psychologist and legal scholar at Widener University School of Law. He notes that alcoholics have brain abnormalities. Do we give them a pass if they kill someone while driving drunk?
***
At trial, Jonathan Brodie, a psychiatrist at NYU Medical School who was the prosecution's expert witness, went further. Even if Dugan's brain is abnormal, he testified, the brain does not dictate behavior.

"There may be many, many people who also have psychopathic tendencies and have similar scans, who don't do antisocial behavior, who don't rape and kill," Brodie says.

The jury seemed to zero in on the science, asking to reread all the testimony about the neuroscience during 10 hours of deliberation. But in the end, they sentenced Dugan to death. Dugan is appealing the sentence.

With this and the U.S. Supreme Court case allowing governments to indefinitely detain pedophiles, the halcyon days of believing in rehabilitation for criminals seem to be over. If there was one piece of advice I could give this upcoming generation of sociopaths, it would be to master the ability to authentically mimic the empath's exaggerated remorse and self-hate, a performance that is quickly becoming necessary to keep the lynch mobs at bay.

Sociopaths feel empathy (sort of)

Recent research suggests that sociopaths can feel empathy (or at least their mirror neurons light up as if they are feeling empathy) when directed to put themselves in the shoes of someone else. From the BBC News:

Psychopaths do not lack empathy, rather they can switch it on at will, according to new research. Placed in a brain scanner, psychopathic criminals watched videos of one person hurting another and were asked to empathise with the individual in pain. Only when asked to imagine how the pain receiver felt did the area of the brain related to pain light up. Scientists, reporting in Brain, say their research explains how psychopaths can be both callous and charming. The team proposes that with the right training, it could be possible to help psychopaths activate their 'empathy switch', which could bring them a step closer to rehabilitation. Criminals with psychopathy characteristically show a reduced ability to empathise with others, including their victims. Evidence suggests they are also more likely to reoffend upon release than criminals without the psychiatric condition.

I always wonder at this logical jump -- that a lack of empathy is the primary reason why sociopaths reoffend as opposed to, say, fearlessness, overoptimism, etc.? Maybe, but I haven't seen actual research on the issue, only idle speculation. The LA Times reporter, Geoffrey Mohan, takes this flawed line of reasoning one step further and suggests that only automatic empathy will do the trick:

But there is a substantial gulf between automatic empathic responses and those that result from cognitive control. Because a psychopath likely cannot be "trained" to summon up empathy to counterbalance manipulative and violent behavior, therapies would have to focus on embedding the process where it belongs: in the largely unconscious emotional regulating centers of the brain.

I disagree. I think sociopaths can be trained. I think that is the biggest implication of this recent research. And I think other research has shown that conscientiousness is the trait most strongly correlated with successful sociopaths vs. unsuccessful sociopaths. And what is conscientiousness but the acquisition of good habits, i.e. training. Plus, my own experience suggests that sociopaths can be trained. Readers of the book will recognize Ann as my trainer. So, it's an odd assertion to make, that sociopaths can't be trained. But luckily the researchers seem to share my view:

"From a therapeutical point of view, the big implication of our study is it does not seem to be the case that they have broken empathy per se,” Keysers said. “That would suggest that what therapies need to do is not so much try to create empathy in them, but try to make empathy more automatic and potentially do so by making the social cues of others more salient, so they will always be drawn into this empathy mode that they can activate when they want to.”

Especially given what we know of cognitive empathy being something we can practice.

So do I think that this is major news and will change the way we view sociopaths? Maybe it will change the common (mis)conceptions regarding sociopathy, but it is completely in line with recent trends in sociopathy research. For instance, Joseph Newman has a similar theory that sociopathy is largely an attentional issue, and that when you direct their attention to emotions (apparently even to the emotions of others), they experience them in relatively "normal" ways. The researchers of this current study agree:

Theories of psychopathy’s origins center around deficits in instrumental learning and attention. Keyser’s conclusions merge with those hypotheses. Of particular note were scans that showed abnormal activation in the amygdala, an area of the paralimbic system associated with emotional learning. Psychopaths may lack clues to the salience of social stimuli, an attribute shared to a certain degree with autism spectrum disorder. 

[I have often wondered if sociopathy is an autism spectrum disorder]

Psychopaths therefore may not be able to develop more complex structures of rules and morals, said Keysers.

“They don’t have this tendency that we normally have to be drawn into what the other person is feeling, and you can rephrase that as an attentional deficit,” Keysers said. “They simply don’t attend to what is going on with other people, automatically.”

So no, I don't think this is so different from what has been the recent trend in how researchers have viewed sociopathic empathy, particularly when you consider that sociopaths have always been acknowledged to have cognitive empathy, just not emotive empathy. Research suggests that cognitive empathy can be enhanced by attention directing exercises such as perspective taking. I have consistently said that sociopaths are able to put themselves into the shoes of another and imagine what it might be like to be that person, which possibly explains why we're so good at manipulation. Also, I have even experienced this type of focused empathy accidentally.

Things I would like to see explored further:

• Is this sort of empathy different from mentalizing?
• Can anyone empathize with things they haven't yet experienced or the experiences of others that are dissimilar to them (e.g. white people don't empathize with Trayvon Martin as much as African Americans do)?
• What is the relationship between this attentional empathy and being moved (manipulated into feeling your own feelings in response to stimulus?)

So this is good news for sociopaths and our fight against the stigma, but knowing how much some people blindly hate sociopaths, my guess is that this is eventually going to be used to argue that sociopaths are just being lazy or opportunistic when they choose not to empathize.

As a side note,  apparently in the Netherlands psychopaths have access to the insanity defense? "Keysers and his team were given access to offenders who committed violent crimes, such as rape and murder, but who were found not responsible due to a psychopathy diagnosis." Sort of not surprising for the Dutch. 

Freudian look at psychopaths?

This was a sort of interesting, Freudian influenced approach to explaining psychopaths that may resonate with some of you, J. Reid Meloy (author of "The Psychopathic Mind: Origins, Dynamics, and Treatment") with subsequent commentary by Donald Carveth. He is a little bit more on the Hare side of his understanding (i.e. not too sympathetic), but it is a pretty decent overview of some of the more famous studies of sociopaths.

Brain scans

From a reader:

A friend sent this to me and I thought you would be interested. It's about the mainstream acceptance of neuro imaging, and some of the potential pitfalls that I was not previously aware of.

Here are selections from the article:

Fancy color pictures of brains in action became a fixture in media accounts of the human mind and lulled people into a false sense of comprehension. (In a feature for the magazine titled “Duped,” Margaret Talbot described research at Yale that showed that inserting neurotalk into a papers made them more convincing.) Brain imaging, which was scarcely on the public’s radar in 1990, became the most prestigious way of understanding human mental life. The prefix “neuro” showed up everywhere: neurolaw, neuroeconomics, neuropolitics. Neuroethicists wondered about whether you could alter someone’s prison sentence based on the size of their neocortex. 
***
Fancy color pictures of brains in action became a fixture in media accounts of the human mind and lulled people into a false sense of comprehension. (In a feature for the magazine titled “Duped,” Margaret Talbot described research at Yale that showed that inserting neurotalk into a papers made them more convincing.) Brain imaging, which was scarcely on the public’s radar in 1990, became the most prestigious way of understanding human mental life. The prefix “neuro” showed up everywhere: neurolaw, neuroeconomics, neuropolitics. Neuroethicists wondered about whether you could alter someone’s prison sentence based on the size of their neocortex. 
***
The real problem with neuroscience today isn’t with the science—though plenty of methodological challenges still remain—it’s with the expectations. The brain is an incredibly complex ensemble, with billions of neurons coming into—and out of—play at any given moment. There will eventually be neuroscientific explanations for much of what we do; but those explanations will turn out to be incredibly complicated. For now, our ability to understand how all those parts relate is quite limited, sort of like trying to understand the political dynamics of Ohio from an airplane window above Cleveland. 
***
Which may be why the best neuroscientists today may be among those who get the fewest headlines, like researchers studying the complex dynamics that enter into understanding a single word. As Poeppel says, what we need now is “the meticulous dissection of some elementary brain functions, not ambitious but vague notions like brain-based aesthetics, when we still don’t understand how the brain recognizes something as basic as a straight line.”

Important stuff to remember when we read articles promising that psychopath brains are X or Y, explaining Z.

Sociopathy as spectrum disorder

I thought this was an interesting and straightforward explanation of what it means for something to be a spectrum disorder, particularly when we're talking about psychopathy, and the difficulties it introduces in terms of understanding and diagnosing individuals with that particular disorder. From a Wall Street Journal book review of the Wisdom of Psychopaths:

In one of her stand-up comedy routines, Ellen Degeneres riffs on those commercials for depression medications that begin: "Do you ever feel sad?" Ms. Degeneres's sardonic response: "Yes, I'm alive!" Everyone occasionally feels down, so mild depression might indeed be considered part and parcel of living. Recent research suggests that, like pain, it may be a way of coping with a bad situation by making a change. One problem with most psychological diagnostic tools, in fact, is that they attempt to squeeze into a well-defined box behaviors that are, on some level, not all that unusual. So the criteria lists grow and the diagnostic labels broaden into what psychologists call "spectrums."

"Psychopathy" is a spectrum personality disorder characterized by callousness, antisocial behavior, superficial charm, narcissism, grandiosity, a sense of entitlement, poor impulse control, and a lack of empathy or remorse. Popular culture invariably associates psychopathy with serial killers like Ted Bundy, who, after raping and murdering numerous women in the 1970s, boasted that "I'm the most cold-hearted son of a bitch you'll ever meet." Yet a slate of publications on psychopathy over the past two decades—from Robert Hare's path-breaking 1993 book "Without Conscience" to Simon Baron Cohen's 2011 "The Science of Evil"—reveals that about 1% to 3% of men in the general population could be classified as psychopaths. That is more than four million people in the United States alone, and they aren't all potential Ted Bundys.

The spectrum of psychopaths includes CEOs, surgeons, lawyers, salesmen, police officers and journalists. According to Kevin Dutton, the rest of us could learn a thing or two from many of them. In "The Wisdom of Psychopaths," the Cambridge University research psychologist notes that in many circumstances, such as in business, sports and other competitive enterprises, it is beneficial to be a little charming, tough-minded, impulsive, risk taking, courageous and even a bit socially manipulative. We have the makings of a dangerous psychopath only when that little bit of charm becomes devious manipulation; when self-confidence escalates to grandiosity; when occasional exaggeration morphs into pathological lying; when tough-mindedness devolves into cruelty; and when courageous risk taking slides into foolish impulsiveness. 

It's this sort of fuzziness that has led me to sometimes question whether I think that psychopathy is even a real thing. The difficulty is the heterogeneity in the psychopath population and fuzzy dividing lines between normal behavior (if perhaps a little extreme or rare), and disordered behavior. Of course there is evidence that psychopath brains look different, although the research is still very young. Still, I often have wondered what my brain would look like in one of these fMRI tests that some psychopath researchers perform, would it look normal or abnormal and in the same ways that psychopaths brains appear? I have often thought that my brain has to look abnormal, that there is no way I could have such a different way of thinking than everyone else without my brain reflecting that difference. But people say that is a common fallacy -- believing that you are different from everyone else. Then again, I probably prefer that error than to erroneously assume that everyone thinks exactly like me.

More on genius

So I just noticed that the recent Scientific American issue is all about genius, including this interesting assertion about what it is like to think like a genius (and can people promote this sort of thinking in their own brains?). From the (free) summary of the (subscription only) article "Boost Creativity with Electric Brain Stimulation":


A great idea comes all of a sudden. In the depths of the mind, networks of brain cells perform a sublime symphony, and a twinkle of insight pops into consciousness. Unexpected as they are, these lightbulb moments seem impossible to orchestrate. Recent studies suggest otherwise. By freeing the mind of some of its inhibitions, we might improve creative problem solving.

The human brain constantly filters thoughts and feelings. Only a small fraction of the stimuli impressed on us by our environment ascends to the level of conscious awareness. Prior learning enforces mental shortcuts that determine which sensations are deemed worthy of our attention. Our laboratory is investigating whether we can weaken these biases and boost openness to new ideas by temporarily diminishing the neural activity in specific brain areas.

I thought this was interesting, that part of the key to being more genius is what is coming into our conscious awareness, particularly as a person who has forced awareness of many mundane decisions into my conscious thought even from a very young age. Perhaps even more the money quote with regards to the connection between this article on genius and sociopaths having unique insight:

Genius, rare as it is, must demand a qualitatively different view of the world than what most of us experience. Austrian physician Hans Asperger, whose name is associated with the eponymous condition on the autism spectrum suggested that, '"a dash of autism' might set brilliant minds apart. We have been investigating this hypothesis by using weak electric current to modulate brain activity in healthy people in our laboratory. The effects fade in an hour, preserving normal cognition. This method of brain stimulation is safe and portable - a 'creativity cap' - that anyone might use to spur creativity on demand.

Carrie Mathison from the Showtime drama Homeland anyone? Particularly on the tails of the recent article on how to raise a genius, I like this idea that genius demands a qualitatively different view of the world than what most people experience. Especially when that requirement is taken into consideration, it does seem a damn shame to kill off sociopathic babies once they can be identified as aberrant, no?

Brain trials

A reader sent me this article from a legal publication regarding the use of neuroscience evidence in the courtroom. I've discussed before about how the diagnosis of psychopath is often used in parole hearings as an argument against granting the prisoner parole (see also this NPR article about a prisoner named Robert Dixon). This article was a fun read because it uses stories that illustrate the difficulties well:


Take the case of a 40-year-old married schoolteacher from Virginia who during the year 2000 inexplicably began to have a sexual interest in children. He surreptitiously collected and viewed child porn on the Internet and was convicted of trying to molest his stepdaughter. The night before sentencing, he complained of horrible headaches. At the hospital he talked of suicide, made sexual advances to staff, spoke of raping his landlady and urinated on himself.

An MRI revealed that the teacher had a large orbitofrontal tumor, a growth on an area of his brain associated with social behavior. After surgeons removed the tumor, he was no longer considered a threat and completed a sexual rehab program. But a year later, he began getting headaches and once again collected pornography. Another MRI showed the tumor had regrown, and it was removed again.

Dr. Russell Swerdlow, a neurologist who treated the teacher at the hospital and later wrote about the case in the Archives of Neurology, says that such radical behavioral changes are not surprising. “But it was the first case in which the bad behavior was pedophilia,” says Swerdlow, a neuro-scientist and professor at the University of Kansas. “What was so striking about this was his inability to act on his knowledge of what was right or wrong.”

Swerdlow says when pathways are broken between the orbitofrontal lobe and the amygdala, a part of the brain involved in emotional responses and decision-making, the result can be impulsive behavior. “You don’t get the feedback that controls your decisions. You don’t have the brakes on your behavior,” he says.

Morse says that while the teacher may deserve some mitigation in sentencing because of his ailment, it’s not clear whether he lacked the ability to control his impulses, or simply chose not to. “People want to say his tumor made him do it. He made him do it. There is always a reason people do it,” Morse says. “We don’t give a pass to the other pedophiles. He felt an urge, which he understood and did not resist, but acted on it.”

While it’s true that not everyone who suffers brain damage commits criminal acts, there are plenty of anecdotal cases in medical literature showing that it causes behavioral changes, including impulsiveness, depression, aggression, inappropriate sexual behavior, lack of thought control and violence among people who prior to their injuries did not exhibit such behaviors. But how that should be considered in criminal culpability—and what science can truly explain—remains murky.

I love this story because when you start reading it you think, this poor guy. He's not the one making the decisions, it's his broken brain. Then you get to the part about how we don't give a pass to the other pedophiles and then it becomes clear that this issue is thornier than most people have considered. For instance, lucky you (most of you) to have not been born with a sexual lust for children. But just wait until you get some crazy brain tumor! Then you are truly up Shit Creek.

Lighter sentencing for genetic predispositions

This NY Times article discusses new experimental evidence that suggests that when judges (not juries) sentence criminals for whom there is evidence of genetic predisposition to violence and crime (in this experiment, psychopaths), they give lighter sentences than they otherwise would:

The new experiment focused on sentencing by judges, not jury verdicts. It found that neurobiological evidence reduced judges’ sentences by an average of about 7 percent for a fictional defendant convicted of battery and identified as a psychopath.


In the study, three researchers at the University of Utah tracked down 181 state judges from 19 states who agreed to read a fictional case file and assign a sentence to an offender, “Jonathan Donahue,” convicted of beating a restaurant manager senseless with the butt of a gun. All of the judges learned in their files that Mr. Donahue had been identified as a psychopath based on a standard interview — that is, he had a history of aggressive acts without showing empathy.

The case files distributed to the judges were identical, except that half included testimony from a scientist described as “a neurobiologist and renowned expert on the causes of psychopathy,” who said that the defendant had inherited a gene linked to violent, aggressive behavior. This testimony described how the gene variant altered the development of brain areas that generate and manage emotion.
***
The judges who read this testimony gave Mr. Donahue sentences that ranged from one to 41 years in prison, a number that varied with state guidelines. But the average was 13 years — a full year less than the average sentence issued by the judges who had not seen the testimony about genetics and the brain.
***
“But then those who read about the biological mechanism subtracted a year, as if to say, ‘This guy is really dangerous and scary, and we should treat him as such, but the biological evidence suggests that we can’t hold him as responsible for the behavior,’ ” said James Tabery, an assistant professor of philosophy at Utah.
***
This mixed result — added punishment for the defendant’s being identified as a psychopath, tempered by empathy for his having a possible genetic predisposition — provides a good illustration of what legal researchers call the double-edged sword of biobehavioral evidence. On one hand, a biological predisposition suggests that a person is likely to be dangerous in the future and should get a longer sentence; on the other, it implies a lower threshold of responsibility. The evidence could cut either way, depending on the judge.

Nurture trumping nature

I have posted before about James Fallon, neuroscientist, University of California, Irvine, professor, psychopath expert, and successful psychopath (?) before.  I thought this video was worth posting as well because it targets more the personal experience of what his family thinks about who he is and his childhood was instrumental in Jim not developing into a killer, despite his brain and genetic predispositions.




6:55: His mother tells him about how Lizzie Borden is a cousin of his.  On one line of his family there were at least 16 murderers.

7:54: He decides to check the brain scans and DNA of his family members for the brain signatures and genes linked to psychopathy.  He discovers everyone is normal except for him, who has the brain scan signature of a killer and all of the genetic markers predisposing to impulsivity, violence, etc.

10:05: Reaction from his family "I knew there was always something off.  It makes more sense now."  "Everything that you would want in a serial killer he has in a fundamental way."  "It was surprising but it wasn't surprising."  "He's always had a standoffish part to him."

11:00: Jim is honest with himself "I have characteristics or traits, some of which are . . . psychopathic." he gives the example of how he could blow off an aunt's funeral.  "I know something's wrong, but I still don't care."

11:40: Why wasn't he a killer?  "Whether genes are triggered or not will depend on what happens in your childhood."

12:28: "It turns out that I had a unbelievably wonderful childhood."

I think this is an interesting and accurate portrayal of what a high functioning psychopath might look like.  I think people expect to see very obvious differences, but frequently they're not obvious or they're not really visible.  It's like this response from Jennifer Kahn, author of that NY Times Magazine article on psychopathic children, when asked about whether the child's behavior was more or less extreme than she expected:

I think I expected Michael to be more immediately extreme. When I arrived, he was on his good behavior, but he did get extreme later in the night. Something that Waschbusch said he struggles with is that it is hard to define what is prepsychopathic behavior and what is behavior caused by a different kind of problem — it does tend to cross different diagnoses. It wasn’t the screaming or fits or slamming the toilet seat that struck me; it was the calculated coldness and the flip between emotional states. But I had expected it to be more obvious. When I entered the house, of course, I was thinking of adult psychopaths who have led criminal lives for decades, which is normally how they come to our attention. I was maybe expecting a child version of that, but of course that’s kind of ridiculous. Even among adult psychopaths, that would be a small minority.