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Authors: Dean Haycock

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By one estimate, criminal psychopaths cost the U.S. economy at least $460 billion per year (in 2009 dollars) in direct and indirect costs. This figure includes lost property and the expense of finding, arresting, charging, trying, defending, and incarcerating psychopathic offenders. The figure would be even higher if the costs of keeping psychopaths in psychiatric hospitals and treating victims of violent crime perpetrated by psychopaths were included in the estimate.
25
An unknown cost is the psychological damage both criminal and non-criminal psychopaths produce. Even if a psychopath does not break the law, he may break people’s spirits. Psychological abuse of spouses and family members by psychopaths is a common topic in self-help groups and on several online forums. Some clinical psychologists like Martha Stout, Ph.D., author of
The Sociopath Next Door
, have acquired specialized experience treating patients who have been victimized by psychopaths.

Domestic psychological abuse is tragic enough. But for an estimated 1.3 million women who are victimized by current and former spouses or other intimate partners each year in the U.S., the abuse is both psychological and physical.
26
And an estimated 15 to 30 percent of the men responsible for this abuse are psychopaths.
27

Chapter Four

A Problem Just Behind the Forehead

B
URLY, BEARDED JAMES FALLON
tells people he has the brain of a psychopathic killer.
1
And he has some brain scans he thinks back up his claim.

The PET scans behind his surprising claim—and which have provided entertaining material for his lectures—were taken where he works. He’s Professor Emeritus of Anatomy & Neurobiology and Professor of Psychiatry & Human Behavior in the School of Medicine at the University of California, Irvine (UCI). There he studies higher brain functions at the Human Brain Imaging Lab. Fallon describes his interests as “the neural circuitry and genetics of creativity, artistic talent, psychopathology, criminal behavior, and levels of consciousness.”

A neuroscientist with a forty-year-long, successful career, Fallon, now sixty-six, arranged to have his own brain scanned. He made the decision after his mother, Jenny, recalled some interesting family history during a family barbeque. She knew her son, the scientist, lectured about his research on violent offenders. His lectures covered what he saw in the brains of murderers and what the images revealed to him about the causes of violent behavior. That led Jenny, as she said on NPR, to challenge her son: “Jim, why don’t you find out about your father’s relatives? I think there were some cuckoos back there.”
2

She was right. There turned out to be numerous—and murderous—cuckoos back there, including Lizzy Borden and seven other alleged killers. They were all on his father’s side, to his mother’s amusement. Borden, the most infamous, was acquitted—quite controversially—of the axe murders of her father and stepmother in 1882. One of Fallon’s male ancestors, Thomas Cornell, wasn’t so lucky. He didn’t beat the rap for the crime he was accused of committing: the murder of his mother. He hung for it in 1667.
3

Brain scans and genetic tests of Jenny and of Fallon’s wife, son, and daughters were normal. Fallon’s family has nothing in common with psychopaths or murderers, in terms of their behavior or brain activity. Fallon’s brain, on the other hand, shows the characteristic metabolic sluggishness in the frontal lobes first observed in violent and murderous individuals back in the late 1980s. And among the family members he’s tested, only he has inherited some genes that show up frequently in violent individuals. In fact, his blood test shows he has genes linked to violent tendencies—five in all, including one called the “warrior gene” (although any gene linked to violence might deserve the same nickname).

No single gene makes someone violent or psychopathic. Even inheriting multiple genes can’t do this. If they did, Jim Fallon might have spent more time before a judge’s bench than before his lab bench. Besides the warrior gene, Jim says he inherited genes associated with antisocial behavior, low anxiety, and low empathy. Several encode instructions for making proteins involved in the function of neurotransmitters like serotonin and dopamine. But different versions of genes do influence behavior in some people, some of it unpleasant indeed. Differences in the effect of these genes on brain development, and on the way it receives, interprets, and responds to inputs influence how likely someone like Jim is to turn violent and/or show signs of psychopathy.

The discovery of the warrior gene-violence connection goes back to the late 1980s and early 1990s in the Netherlands. Hans Brunner, a geneticist at the University Hospital in Nijmegen, learned about a family that seemed to be full of men who easily lost their tempers, were aggressive, and, worse, were adding to their rap sheet with entries related to assault, arson, rape, and murder. The women in the family asked the geneticist if their men might be behaving badly because they had inherited something bad.

In 1993, Brunner had an answer for them. It was on the men’s X-chromosome, one of the chromosomes that determine gender. He discovered that the men had inherited a version of a gene that encodes an enzyme called MAOA-L.
4
In the brain, MAOA breaks down important neurotransmitters, such as serotonin, dopamine, and adrenaline. MAO stands for monoamine oxidase; A designates a subtype of the enzyme (sort of like a car model), and L stands for low activity. Since 1993, the low-activity version of the gene—dubbed the “warrior gene” by the press—has been linked in several studies to increased aggressive behavior.
5
A tendency to get into fights or strike out at others is not the same as the goal-directed aggression often seen in criminal psychopaths, but the existence of the MAOA-L gene does strongly support the view that some psychopathic tendencies may be inherited.

Another genetic variation that may be linked to the development of psychopathy affects the metabolism of the neurotransmitter serotonin. Inheriting two long versions of the gene that produces a protein that transports serotonin back into brain cells after it has been released may be a risk factor for the development of psychopathic traits.
6

Prior to checking the status of his own DNA and brain images, Fallon says he analyzed the brain scans of over seventy people, which according to the Wall Street Journal were sent to him by colleagues, psychiatrists, and criminal defense lawyers.
7
It started back in the 1990s when people began sending brain scan images to Jim for him to analyze. “I knew the human brain very well but I wasn’t an expert on murderers or psychopaths or anything like that… . It was just a side thing,” he recalled.
8
Then in 2005, he received a large group of scans to look at. “At this point, Jim knew his colleagues were sending him brain scans of murderers so he decided to make a story. He asked his associates not to identify the scans. He also asked them to include scans of non-violent patients along with those of murderers.”

He easily identified ten normal brain scans. Then he saw a group of scans from patients with major depression and some with schizophrenia. “It was a mixed bag,” he said. He didn’t know there was a pattern in psychopaths, because it wasn’t his main field of study, but he did notice a group of scans that showed inactivity in the prefrontal orbital cortex. Fallon later learned
he had correctly identified the thirty murderers whose scans had been included in the collection of scans.
9

“There was one subgroup of those that had a lot of amygdaloid and cingulate cortex type of activity, so they stood out.” When the code was broken, this subgroup turned out to be psychopaths. “I think because I am not really an expert in this area, it made it easier for me not to be biased. I did not expect any pattern,” he said. “I think that is where it helped.” The first group with prefrontal cortex differences without amygdala and cingulate involvement turned out to be impulsive or reactive murderers. These people killed in a hot-blooded emotional manner as opposed to the cold-blooded manner characteristic of criminal psychopaths.

Fallon’s observations are consistent with some small-scale experiments first published in late 1987
10
and early 1994.
11
The preliminary studies demonstrated the potential usefulness of PET-scanning the brains of people with personality disorders and violent tendencies. Adrian Raine and his co-workers used the technology to look at the brains of twenty-two men accused of murder in 1994.
12

The darkness they saw indicating impaired metabolism in the prefrontal cortices of murderers and accused murderers was obvious, compared to an equal number of non-murderous controls. It suggested that the lack of neuronal activity in this part of the brain was a factor in murderous behavior. A follow-up study three years later found that 41 murderers who pled not guilty by reason of insanity also had reduced glucose metabolism in their frontal lobes compared to 41 controls. This mixed group also showed signs of reduced metabolism in half a dozen other brain regions.
13

These pioneering early studies of violence-prone individuals led the way to current fMRI studies in which people undergoing brain scans are more likely to belong to similar groups: for example, those with psychopathy scores in the certifiable psychopathic range. The earlier studies, like Fallon’s unpublished studies, captured mixed populations of violent individuals and murderers.

Despite a general impression to the contrary among many people, not all—in fact surprisingly few—murderers are high-scoring psychopaths. Some people kill as a result of stress or an isolated, uncontrolled emotional
reaction such as anger or jealousy. More than half of the nearly 13,000 people murdered in 2010 in the U.S. were killed by someone they knew. Nearly one-quarter were killed by a family member. Nearly 43 percent were killed during arguments and just over 23 percent were crime victims. Circumstances surrounding the rest are unknown.
14

Many criminals have antisocial personality disorder but do not reach the amoral or immoral depths of clinical psychopathy. Others kill because their criminal lifestyle forces them into situations where they must use violence. Most criminals—75 percent or so—have antisocial personality disorder, the personality disorder the American Psychiatric Society created to include sociopaths, which the Society still equates with psychopaths. Only a quarter or so of jailed criminals with antisocial personality disorder, however, are true psychopaths as indicated by the standard diagnostic test for that type of personality. This means about one in five prison inmates are estimated to be true psychopaths.

The search database of the U.S. National Library of Medicine and the National Institutes of Health, PubMed, lists 105 articles co-authored by J. H. Fallon. His published papers reflect his scientific interests which, according to his UCI faculty profile include “Alzheimer’s disease, Human Brain Imaging, art, law, culture, and the brain.” He has made significant contributions in several of these areas, including the use of imaging technology to locate genes associated with mental disorders, and research on growth factors and stem cells. He acknowledges that he has not published in the field of psychopathy. His finding is anecdotal.

He described his intriguing anecdotal studies in a TED talk titled Exploring the Mind of a Killer and in the BBC documentary Are You Good or Evil? He has also shared his scientific expertise in different areas of his research on the History Channel, Discovery, CNN, PBS, ABC, and the Wall Street Journal.
15

Nevertheless, the images Fallon finds in the scans of the murderers he examines, and which he finds in his own distinguished, law-abiding brain, are often identical to those of certified psychopaths. (He has avoided releasing his scores on the Hare Psychopathy Checklist, Psychopathic Personality Inventory, and other formal psychological evaluations as well as some casual online tests, but he says they are just short of the cutoffs for psychopathy.)
16
The results like those he saw in his own brain scans are
consistent with those reported in more controlled studies that have resulted in a better understanding of the abnormalities that appear to contribute to the cold-hearted nature of the most extreme psychopaths.

Front and Center

T
HE SAME DARK REGIONS
in Fallon’s neuroimaging self-portrait that shocked him and instantly captured his attention, had captured the attention of other researchers interested in biological psychiatry years earlier. When Fallon points to the section of his brain scan that looks like the brain of a murderer, he points to a part of the frontal lobes called the prefrontal cortex (Figures 8 and 9).

The frontal lobes have been suspects in aggressive and criminal behavior since the 19th century. If you want to find your frontal lobes, imagine you have a bad headache. Place the palm of your hand on your forehead, fingers pointing up. Position the meaty part of your palm at eye level and lay your fingers over the top of your head. Fortunately, your skull prevents you from touching your frontal lobes directly, but if it were not in the way, you would have a pretty good grasp on this tissue that is so influential in determining the type of person you are.

Your frontal lobes are located immediately behind your forehead and extend halfway back across the top of your brain. They are part of the cerebral cortex, the outermost covering of the brain that processes higher brain functions. And the cerebral cortex of the frontal lobes controls some of the most sophisticated higher brain functions. Of course, other parts of your brain contribute to the mysterious task of generating consciousness, creating thoughts, and solving problems. But if you are the type of person who is even moderately successful at, for example, planning for your future retirement, weighing the risks of challenging your boss, worrying what might go wrong if you go sky-diving with an unlicensed instructor, “reading” people and getting along with them, and sublimating your sex drive when the time is not right, then you are doing a pretty good job of using your frontal lobes.

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