Covid-19 and Reactionary thinking

I've been tweeting a lot more. Probably because I think the world has gone a little sideways, but mostly not because of the virus. I know in times of uncertainty people have a tendency to be more fearful (I have noticed people struggle with uncertainty). Others will try to profit and superimpose their previously held viewpoints on the situation in a way that is more opportunistic and transparent than I am used to seeing. I thought this was particularly true of this NY Times piece about how as early as 2006, the United States federal government found that it was 700,000 ventilators short in the event of a pandemic. Rather than just buy more ventilators, it tried to contract with medical device companies to produce some very cheaply. Companies submitted buds, but it wasn't until 2010 (a few months after the H1N1 outbreak, so already too late for the next pandemic) that a contract was signed with a company. So it took  4 years of the government dicking around from realizing it needed 700,000 ventilators to signing a contract to procure those ventilators. Remember, design and production are still years away. 

The lowest bid was for 15% the going rate of ventilators by a very small, unproven company. Why 15%? Apparently the government really didn't feel like this emergency surplus warranted paying retail rates. To me, this is a little like (as I tweeted) leaving my car on the side of the road gasless and waiting until gas prices drop below $3 before I gas it up again. Like knowing that you don't have fire extinguishers for your 50 story building, but waiting until they go on sale for 85% off until you buy any. This alone is not the craziest part of the story to me, in terms of shocking government decisions.

$6M government dollars later, the contracted for medical device company got stalled at FDA approval in 2012 (apparently because it didn't work on infants), but the NY Times article tried to make it seem like the failure was because the company was intentionally purchased by a bigger company to stifle innovation (no sources were named to support this proposition). The contract was finally cancelled in 2014.

But now 8 years after it realized it was short 700,000 ventilators and not being able to get a single one (at least according to the NY Times), instead of just buying ventilators on the open market the federal government again chooses to contract with a medical device producer, Philips. I can't really tell from the gaps in the NY Times timeline, but I think that contract happened around 2014. Philips has also failed to produce any usable ventilator in the past 6 years. Why? The FDA: "It wasn’t until last July that the F.D.A. signed off on the new Philips ventilator, the Trilogy Evo. The government ordered 10,000 units in December, setting a delivery date in mid-2020."

The NY Times take on this, with zero facts to support their argument:

The stalled efforts to create a new class of cheap, easy-to-use ventilators highlight the perils of outsourcing projects with critical public-health implications to private companies; their focus on maximizing profits is not always consistent with the government’s goal of preparing for a future crisis.

Whoa kay! Sounds like a defamation lawsuit to me, especially since Medtronics (the parent company of the original contracting party) is not in any way a public figure under the Supreme Court standard from NY Times v. Sullivan and its progeny.

People have a lot more spicy takes nowadays. The arguments I see most from though-leaders are that these circumstances call for extreme measures, and don't worry we can just trust them that what they're saying is necessary and if we don't comply we lack empathy and are team virus and should be fined or imprisoned. At least, that's according to my local subreddit that is saying that surfers who want to still surf during this pandemic are "entitled fucking children" lacking in "empathy".

I've seen other people savagely (gleefully, I think) tear apart Richard Epstein after this New Yorker interview. Not his ideas, mind you, just him, or perhaps in fairness laser focusing on some ideas they disagree with and ignoring his other points.

I guess that's the most common thing I have seen that scares me, much more than the virus -- that people are no longer willing to attack other people's ideas, they seem to be only attacking people. And the people they attack are people who do not share the same "feelings" they do about what is happening.

Because the truth is even the data we have is extremely all over the place (even when you exclude the the Chinese data and try to account for differences in culture, etc.). If you hear anyone say that they know what is happening, you can know for a fact that there is no definite evidence to prove practically anything. We are in the extreme position of flying blind on almost every level.

So why attack each other personally and not the ideas? And here's what I mean using Epstein as an example. I think the main issue that people seemed to take with Epstein is that he said that viruses evolve, and tend to (1) evolve in response to their hosts responses and they (2) evolve to weaker strains, which I don't know anything about but a quick google turned up innumerable sources that support number 1, including this peer reviewed article from two years ago in the journal of Molecular Biology and Evolution. And again without spending too much time on this issue, I found in support of number two this and this. But read the interview, it's crazy how much of a set-up hit piece it is and how cherry-picked their own experts are to contradict Epstein. They knew ahead how they wanted to discredit Epstein, not just his ideas but to discredit him as a person. Why? Because Epstein made the mistake of asking what is the basis for all of this non-democratic action from the executive branches in this country:

Well, I’m saying in effect, by this particular point—this is not the medical side—is after you start declaring emergencies you have time for reflection and adaptation and modification, which you don’t have in a fire case. So the political point is one which essentially says, when you see governors of three major states putting out statements that their experts have said this, that, and the other thing is a result, and you don’t see the studies and you can’t question the assumption, I regard that as a serious breakdown in the political process. So my view on that particular point is I’d like to know which of these studies they’re relying on. If it’s the New York Times studies, then I thought that that study was mistaken for the reasons that I was trying to give you a moment ago, which is that as the virus becomes more apparent, adaptive responses long before government gets involved become clear.

The craziest thing is he doesn't even criticize them for acting with urgency, he just says that now that we have some down time and this is the new normal, maybe they could do us the favor of explaining what models and assumptions they're basing their decisions on.

I want this too. I'm tired of being subject to mob mentality throughout with people who appear to be (at least to me) fear driven and not thinking as well as I am used to seeing from them, but instead being reactionary and making knee-jerk decisions with lasting consequences on the spur of the moment with seemingly little before-thought. But even some of that, that's ok that's predictable, that's fine. Pandemics, I get it. But what about after thought, i.e. thought after we've jumped to decisions and conclusions about what we think is going on or should be going on? What about allowing new ideas in? What about challenging what we think we know? What about attacking ideas instead of people? What about using data instead of feelings? Can we at least agree that those precepts don't go out the window in an emergency?

Hopefully another we can get back some humility to question our own thinking and that of our leaders, lest we turn out like Hungary.

When we choose how to react in a crisis, let’s strive for consistency. The WHO estimates that 4.6M people die each year from causes directly attributable to air pollution. Worldwide more deaths per year are linked to air pollution than to automobile accidents. What do we do? https://t.co/BBSSy75v7U

— M.E. (@sociopathworld) March 18, 2020

Religious moral reasoning vs. guilt and getting better

A reader sent me this video of David Woods (Christian psychopath) talking about his religious conversion and how he gets pushback from other Christians because he still doesn't feel guilt.

First, him explaining (I don't think super well) about guilt. 

Second, him talking about how religious people insist that feelings of guilt are a necessary part of religious conversion/salvation. 

I remember when I got judged by some members of my own church, they said that it wasn't necessarily what I had done in the past that made me such a bad person, but that the way that I felt about it. I thought that was a totally anticipated reaction for people to have because my religion does emphasize to a certain point one's change of heart over the ledger recording one's actions in life, whether good and bad. That is, someone might have a change of heart at the last minute death row style and still be just as worthy of salvation as someone who had been "good" their entire life. On the other hand, it's obvious a mental health disorder to not have the same feelings of guilt and to expect someone to feel differently is like expecting gay people to not be attracted to members of the same sex. So I feel like this thoughts vs. action issue is something that many if not all religions have had to evolve their thinking on as we learn more and more the limits of controlling one's thoughts and feelings.

A quick word about guilt. The way I explain a sociopath's lack of guilt is through sense of self. Shame is something that society imposes on you to make you feel bad because you have violated one of their moral constructs. Guilt is a feeling that you have violated your own moral construct or self construct. For instance, if you think of yourself as being an honest and generous person, you may feel guilt if you behave in a dishonest or selfish way. But if you don't think of yourself in any sort of terms, either as being dishonest or honest, you won't ever have experience guilt because you won't ever violate your own self concept. I think sociopaths can regret that things didn't play out differently, and they can even feel remorse when they understand that it was their action that led to things paying out poorly or hurting people that they didn't want to hurt but maybe in a moment of extra impulsivity they did hurt.

Here's his video saying that before a sociopath can get better, he has to see himself as having a problem or being flawed or missing something, rather than seeing sociopathy exclusively as a super power.

Knowledge vs. Understanding

One thing I hear a lot from people is that sociopaths know right and wrong, i.e. if you asked them to say what is the right thing to do in a particular situation, they'd more than likely give you the "right" answer. Consequently, the argument goes, sociopaths are responsible for all of their actions to the same degree as a normal person. I've tried to use the analogy before of how most children understand the "right" answer regarding stealing, hitting, not waiting their turn, not sharing, etc. but that we don't expect them to have the same capacity to behave well as we would a neurotypical adult. I think this difference between knowing something and understanding something was illustrated well in this video.



On the positive side, just like this guy learning how to ride the messed up bike, I think that sociopaths can learn to perspective take (which is basically empathy) and to learn to think more of others and other "good" behavior (or behavior which promotes "good" actions). I actually think the bike analogy is really good because like the hard wiring we have regarding riding a bike, the sociopath got hard wired at a very early age -- hard wiring that is very difficult to ignore or bypass. Just as the man describes needing to concentrate the whole time while riding the messed up bike and if anything should happen to distract him, he crashes, even a sociopath that has learned the "good" behavior mentioned above will likely socially or morally "crash" if there are too many other things taking up his or her cognitive load. I do think with practice the sociopath can get better and better, like learning a foreign language, but we should not expect sociopaths to just understanding good behavior automatically, just like we shouldn't expect a normal person to understand how to ride the messed up bike automatically. 

The origins of criminality as a feature of sociopathy (part 3)

Because it largely captures people who commit crimes, either sociopathic or non, the PCL-R is both over-inclusive of non-sociopathic criminals and under-inclusive of non-criminal sociopaths. (Id, citing Lilienfeld, 1994.) At best, research based on the PCL-R can be characterized as “a literature on unsuccessful psychopathy.” Id. However not all sociopaths are unsuccessful. Rather the “great majority of psychopaths” have (Id, quoting Hercz, 2001, ¶ 11.) via their “ individual differences in talents and opportunities” channeled their psychopathic tendencies not into criminality, but into heroism, worldly success, etc. Id, citing Cleckley, 1976; Harkness & Lilienfeld, 1997; Lilienfeld, 1998; Lykken, 1995. Hare himself has conceded, most sociopaths are not criminals.

Although Hare never filed suit, he successfully delayed publication of Skeem and Cooke’s article by three years. He was also roundly criticized as improperly interfering with the peer review process. In an article titled “Fear Review,” Scientific American writes : “’It was [a] shock,’ Skeem says of Hare's legal threat. ‘this is not about Professor Hare, and it's only incidentally about the Psychopathy Checklist,’ she says. ‘The focus was really on how we could move the field forward.’”

Hare conceded in his response to Skeem and Cooke that the PCL-R does not embody the concept of psychopathy, nor is criminality a necessary component, but there are only twenty factors and three of them specifically deal with criminality: “criminal versatility”, “juvenile delinquency” and “revocation of conditional release” (revoked parole). Another is “many short-term marital relationships”. Only half of the factors track Cleckley sociopathy.

How did non-Cleckley traits enter the PCL-R?

[B]ecause participants in the PCL development sample were criminals rather than nonincarcerated patients or nonpatients, it seems likely that the initial candidate pool included many more deviance-related items, such that [Cleckley’s] positive adjustment indicators dropped out in the selection process. The result is that the PCL-R, compared with Cleckley’s original diagnostic criteria, contains items that are uniformly indicative of deviancy and psychological maladjustment.

Patrick, et al. (2009).

Studying exclusively criminals and then assuming sociopathy must be related to criminality seems like an obvious sampling error. If I exclusively studied my church congregation for sociopathy, could I properly infer a connection between sociopathy and organized religion? Even Hare admits “the majority of psychopaths aren't criminal,” so how could he be satisfied basing his test exclusively on criminals?

Despite round criticism from the psychological community, the PCL-R’s psychopath has left a lasting academic and public impression. Notwithstanding mounting research to the contrary, the dominant popular view of sociopathy is Hare’s criminal recidivist remorseless killer. This is the psychopathy of Hollywood murder movies. I too am scared of such a person, although I haven’t yet encountered one.

Modern researchers remain divided between Cleckley’s carefree bon vivant and Hare, Rollins, McCord and McCord’s criminal deviant.  While Cleckley’s view of sociopaths amounted to emotional colorblindness, Hare et al. depict a “bad egg” rife with moral rottenness – a severely emotionally damaged individual characterized by a loveless and guiltless existence of unrestrained malice for fellow man. Id. Where Cleckley saw “boldness,” they see “meanness.” Where Cleckley saw a lack of connection to the sociopath’s own feelings and the feelings of others, they see a vicious disregard for the feelings of others. Id. Cleckley sought to understand underlying thought patterns, they sought to label external behavior. Cleckley saw a potential patient, they see a social predator. Cleckley saw a problem for which he was seeking a cure.[i] They see a problem that needs to be identified and isolated to protect society, or as Hare has said:

Measurement and categorization are, of course, fundamental to any scientific endeavor, but the implications of being able to identify psychopaths are as much practical as academic. To put it simply, if we can't spot them, we are doomed to be their victims, both as individuals and as a society.

Hare’s remorseless criminal psychopath is associated with “Factor 2 psychopathy”. While Factor 1 traits track Cleckley’s sociopath, Factor 2 adds new traits largely associated with deviance. Not surprisingly, there is little correlation between Factor 2 and Factor 1 traits. In fact, some flatly contradict each other:

•         High aggression, impulsivity, and sensation seeking. Harpur et al., (1989); Hare, (1991).
•         Aggression provoked by reactionary anger. Patrick & Zempolich, (1998); Porter & Woodworth, (2006).
•         High levels of alcohol and drug dependence. Hare, (2003); Smith & Newman, (1990).
•         Deviant behavior.  Hall et al. (2004)
•         High disinhibition and boredom, anger, alienation, distress at negative everyday events. Id.
•         Low conscientiousness and low interest in achievement. Id.
•         Low personal socioeconomic status. Id.
•         Historic and future crimes against people, including violent crimes. Skeem, Mulvey, and Grisso (2003)
•         High aggressiveness. Id.
•         Low agreeableness and lower connection to or interaction with other people. Id.
•         High FFM neuroticism (worrying or negative feelings about everyday incidents), low FFM agreeableness, and low conscientiousness.

o   Interestingly, these are exactly opposite of the Factor 1 results for these categories.

Patrick, et al. (2009).

How can the same group be characterized by both high emotional reactiveness and low emotional reactiveness? Are they angry anxious drug addicts or are they happy-go lucky charmers? Are they impulsive sadist below-the-poverty-line loners or socially dominant Machiavellian CEOs? Are we looking at violent offenders who have a hard time regulating their overpowering emotions or feckless opportunists who have a hard time feeling their own or others’ emotions? Are they primarily emotionally or intellectually driven? Reactive or proactive?

As researchers have posited, the same group can’t really be both, unless we’re talking about two or more separate but related things. Perhaps, as some have suggested, one thing is more nature and the other nurture. Some say one is a sociopath and the other is a psychopath. Or one is a primary sociopath and the other a secondary sociopath. Some say they have the same underlying cause, but only manifest differently. For example, that sociopathy manifests itself naturally in boldness, and meanness is only what happens when you combine sociopath plus risk factors, e.g. childhood neglect or abuse, low socioeconomic status, low education, single parent household, etc. When Cleckley’s emotional blindness is given prosocial outlets, they argue, it can lead to “social efficacy, imperturbability, and tolerance of danger” and if not, “impulsivity, rebelliousness, alienation, and aggression.” Id. This would explain the shared traits (fearlessness and boldness) you see between criminal and non-criminal sociopaths as well as the differences in behavior between the two.[ii]

---

[i] Cleckley’s position was that he knew of no treatment, but he blamed it in part on the collective evasion of the issue by the psychological community and society at large rather than any definitive evidence of there being no treatment:

Although I spared no effort to make it plain that I did not have an effective therapy to offer, the earlier editions of this book led to contact with psychopaths of every type and from almost every section of the United States and Canada. Interest in the problem was almost never manifested by the patients themselves. The interest was desperate, however, among families, parents, wives, husbands, brothers, who had struggled long and helplessly with a major disaster for which they found not only no cure and no social, medical, or legal facility for handling, but also no full or frank recognition that a reality so obvious existed.

….the psychopath presents an important and challenging enigma for which no adequate solution has yet been found. Although still in the unspectacular and perforce modest position of one who can offer neither a cure nor a well-established explanation, I am encouraged by ever increasing evidence that few medical or social problems have ever so richly deserved and urgently demanded a hearing.

Cleckley, “Mask of Sanity”.

[ii] See, e.g.:

“The boldness component of psychopathy, which is tapped weakly and incompletely by the items of the PCL-R, is important to distinguish in turn from the meanness component, which is well represented in the PCL-R. One reason is that the distinction between boldness and meanness is crucial to reconciling Cleckley’s conception of psychopathy with that advanced by more criminologically oriented theorists (e.g., McCord & McCord, 1964; Robins, 1966). Another is that boldness, although phenotypically distinct from meanness, appears to share a key etiologic substrate (i.e., diminished fear capacity). This raises the important developmental question, discussed in the last major section below, of what intersecting etiologic factors give rise to meanness as opposed to boldness in temperamentally fearless individuals.

Yet another reason is that the construct of boldness is likely to be of unique importance in understanding so-called “successful psychopaths”: individuals exhibiting high levels of charm, persuasiveness, imperturbability, and venturesomeness who achieve success in society as military, political, or corporate-industrial leaders (cf. Lykken, 1995).”

Patrick, et al. (2009).

The origins of criminality as a feature in sociopathy (part 2)

Cleckley’s sociopath was “bold”, boldness here being “a capacity to remain calm and focused in situations involving pressure or threat, an ability to recover quickly from stressful events, high self-assurance and social efficacy, and a tolerance for unfamiliarity and danger. Terms related to boldness include fearless dominance (Benning, Patrick, Blonigen, et al., 2005), daringness, audacity, indomitability, resiliency (Block & Block, 1980), and hardiness (Kobasa, 1979).” Id. Bold individuals are likely to show: “social dominance, low stress reactivity, and thrill–adventure seeking (Benning et al., 2003; Benning, Patrick, Blonigen, et al., 2005) . . . imperturbability, social poise, assertiveness and persuasiveness, bravery, and venturesomeness.” Id.

Boldness was evident in [Cleckley’s] case descriptions and diagnostic criteria in terms of poise and high social efficacy, absence of anxiety or neurotic symptoms, diminished emotional responsiveness, imperviousness to punishment (“failure to learn by experience”), and low suicidality. Other historic writers concerned with psychopathy in psychiatric patients as opposed to criminal samples (e.g., Kraepelin, Schneider) also identified bold externalizing types. Id.

Cleckley studied non-criminal sociopaths at a large inpatient facility. No other researcher has focused so extensively on non-criminal sociopaths.

Most researchers studied criminals, and consequently defined sociopathy as a dark strain of criminal deviance. Early researchers William Maxwell McCord and Joan McCord painted a picture in “The Psychopath: An Essay on the Criminal Mind” (1964) of a socially detached, predatory, aggressive, and remorseless individual plagued by angry-reactive forms of aggression and resultant criminality. Similarly Lee Robins, whose work underlies the DSM-V’s “Antisocial Personality Disorder” (ASPD), focused on a maladjustedness marked by persistent aggression, criminality, and destructiveness. Robins (1966, 1978).

Around that same time, Robert Hare developed his Psychopathy Checklist (now revised, PCL-R), based on the Canadian criminal population. The PCL-R is the most popular diagnostic tool for sociopathy. Hare based it on Cleckley’s sociopath, however, it is distinctly darker:

In contrast with Cleckley’s portrayal of psychopathic patients as personable and ostensibly well meaning but feckless and untrustworthy, this latter perspective conceptualizes psychopathic individuals as cold, abrasive, and aggressively exploitative in their interactions with others.

Patrick, et al. (2009).

Cleckley saw “boldness.” Hare substituted “meanness.” Why? Interestingly, Hare’s own early work also found boldness instead of meanness. Id. What changed?

Alice, a sociopath I met in Australia, theorizes that it wasn’t the sociopaths that changed, but Hare. Alice thinks Hare is biased. In fact, she goes so far as to tell me she believes he’s a subclinical narcissist. Her evidence for narcissism includes Hare’s statements that suggest he has a fragile ego and needs to be liked by others. For instance, you could read the following statement as a theory about how most people feel, or you could read between the lines and see someone who is overly concerned with how he is perceived by others:

“We are haunted to some degree by questions about our self-worth. As a consequence, we continually attempt to prove to ourselves and others that we are okay people, credible, trustworthy, and competent.”

He does seem to take the misdeeds of sociopaths personally, for example he warns:

“All the reading in the world cannot immunize you from the devastating effects of psychopaths. Everyone, including the experts, can be taken in, conned, and left bewildered by them.”

Hare speaks from personal experience. He is on record describing his first encounter with a sociopath “Ray” as a long con in which Ray influenced Hare to break prison rules. Hare said he did what Ray asked to build a “rapport”. Due in part to Hare’s influence, Ray received a plum job in the prison mechanic shop. When Hare’s tenure at the prison ended, Ray performed a tune-up on Hare’s car. The brakes failed while Hare was driving down a hill, family in tow. A local mechanic confirmed that the brakes had been rigged with a slow leak. 

Alice thinks this early experience and his continuing inability to build a rapport with prison sociopaths caused him to harden his heart against them. Alice thinks he sought payback by portraying them in the worst psychological light possible, destroying their possibility of parole.

Alice’s theory for Hare’s anti-sociopath bias is consistent with the facts as we know them.

To give you an idea of Hare’s lack of scientific objectivity, in his book Without Conscience: The Disturbing World of the Psychopaths Among Us he calls sociopaths the “monsters of real life” and warns:

“On a more personal level, it is very likely that at some time in your life you will come into painful contact with a psychopath. For your own physical, psychological, and financial well-being it is crucial that you know how to identify the psychopath, how to protect yourself, and how to minimize the harm done to you.”

Hare has manifested other narcissistic traits. In a widely publicized move, he threatened to enjoin the publication of an academic, peer-reviewed article that criticized his PCL-R. The article, by researchers Jennifer Skeem and David Cooke, argued that “the PCL–R weighs antisocial behavior as strongly as—if not more strongly than—traits of emotional detachment in assessing psychopathy.” Consequently, it “is overly saturated with criminality and impulsivity (Blackburn, 2005; Forouzan & Cooke, 2005)” and as such, it “imperfectly maps psychopathy” and “does not fully correspond to Cleckley’s (1941) conceptualization, on which it is purportedly based.”