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Authors: Dean Haycock

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That is what she often found when she visited the scenes of serial killer-related murders. “You have the presence of this cold-blooded, instrumental
violence. It is well planned out. The victims are treated as objects, and there is a level of callousness that is incredible. There is a high risk component to it. There is impulsivity to it. So we don’t just focus on [something like] an addiction and whatever the addiction is associated with.” It is not simply an urge that they need to have satisfied, or a “fix.” “We know there are a lot of other things going on with these people.”

She frequently sees a level of organization in the work of many serial killers that is quite remarkable and unlike what an addict would display, which might betray desperation. “That behavior shows some level of cognitive functioning that allows these individuals to think under pressure, under stress, under anxiety. But again, when you start seeing traits like predatory behavior—they are hunting humans—and instrumental violence, you can see behaviors that manifest traits of psychopathy. We look at the whole gestalt. We don’t just look and try to explain one behavior.”

O’Toole understands that some people who don’t investigate crime scenes as a day job may look at some of the weird, strange, sickening behaviors perpetrated by some serial killers and be tempted to explain it as something other than psychopathic sexual sadism. “But if you ask somebody like me who has seen this behavior over and over again, you are less likely to get a reaction because I’ve seen cannibalism, I’ve seen necrophilia, I’ve seen all of those things. And then I’ve ended up meeting the people that have done these things. So when you start talking about compulsions, I certainly respect the opinions of people who have different explanations for this behavior, but I start looking for paraphilic behaviors.” O’Toole acknowledges that paraphilic behaviors can sometimes be compulsive. “But that is part of what sexual offenders are: they are motivated by their paraphilic behaviors so it is that sexual pathology in the embodiment of somebody who basically does not care about other people; they have no conscience.” Their actions are done to serve themselves and to satisfy their own desires. In these cases, the desires are sexual, but other criminal psychopaths are driven by desires for personal gain. We don’t know enough about the brain to explain why a very small number of criminal psychopaths become serial killers with paraphilia and others follow other criminal pursuits.

O’Toole cannot say a particular serial killer is a psychopath unless he (or—rarely—she) has been evaluated. But when she applies her analysis to
many of the cases she has worked, it allows her to say “in my opinion, this person manifests traits of psychopathy.”

Conduct (Disorder) Unbecoming

Although LTK apparently avoided the Homicidal Triad and a career as a killer or serial killer, according to his clinical history, he nevertheless began to display plenty of other disturbing behaviors from a very young age. In kindergarten, he did not play cooperatively with other children. Perhaps it was his hyperactivity; he was often uncontrollable and unruly. He troubled his teachers and parents in school by skipping classes, by lying, and by stealing. He behaved the same way at home. Although there is no record of him acting violently toward any classmates, he reportedly “committed minor vandalism at home, in kindergarten, and in school,” Hoff and his co-authors learned.

LTK’s bad-boy lifestyle accelerated at the age of twelve. While many of his classmates were playing video games and thinking about girls, LTK was already having sex with older girls. Perhaps his smoking and drinking impressed them. About two years later, he ran away from home for the first time and managed to stay away for several days. Later, the local police started to get to know him when they picked him up for stealing, drunkenness, and disturbing the peace.

Around age sixteen, they arrested him for stealing a car. They added drunk driving to the charge. Shortly after his arrest, he apparently attempted suicide and was taken to a hospital. He escaped. Following his recapture, he entered a special social services program offered by the Norwegian Child Protection Service. Leaving the program at age eighteen, LTK got back together with a former girlfriend, whom he soon made pregnant.

According to the girlfriend, impending fatherhood did nothing to tame LTK’s behavior. He cheated on her, lied to her, continued to drink, and failed to provide financial support. Violent thoughts may have been simmering in LTK because two years later, he attacked a young teenager. He raped her as he held a knife to her throat. He was caught after a second teenaged victim identified him after he raped her.

In prison, LTK again made a suicidal gesture and was again taken to a hospital. He escaped. Again. This happened several more times. Ultimately,
he was released and lived freely as a vagrant while he waited for the results of his legal appeal. Details are unavailable, but the researchers did learn that while LTK was waiting for his appeal to be resolved, he returned to his old habit; he was caught in the act of trying to rape yet another victim.

Back in custody, he resumed his suicidal gestures and claimed he both saw and heard things that were not there. Despite these claims of hallucinations, a psychological exam failed to find an indication of psychosis. There is a good chance LTK was faking it, trying to manipulate the system to his benefit.

He spent some time in a prison and some in a medium-security forensic psychiatric ward. He continued to escape and be recaptured, and was eventually sent off to a psychiatric ward with greater security. Under the constraints of the maximum-security ward, where it was harder to get away with misbehavior or to escape, he appeared to settle down. His behavior in the ward gave no indication that he was intellectually impaired. His history indicates that “Here, he showed good behavioral control, no dramatic mood fluctuations, no self-harming, and no violent or threatening behavior toward others.” In short, his “psychosis” had disappeared.

Such shifts in behavior are not uncommon in confined psychopaths who can appear to control their behavior if they have no opportunity to take advantage of others in a highly structured setting. It can provide an opportunity to scheme in a different way. In LTK’s case, his good behavior—combined with the belief on the part of authorities that he did not pose a threat of violence in the short term—earned him some privileges and a bit more freedom. He exploited his more privileged status in the psychiatric unit by arranging to have contraband, including drugs, brought into the ward and by arranging to have sex with more than one woman from outside his ward.

He impressed Hoff and his colleagues as someone who “does not seem to experience normal depth of emotions.” They added that “he lacks genuine guilt and remorse. Behaviorally he is an impulsive and irresponsible sensation seeker who lives on others and lacks realistic long-term goals.” Like many psychopaths, his behavior suggested that he sought sensations instead of emotional connections to others, and used parasitic behavior to get what he wanted. He gave no indication he could feel love or sorrow or happiness,
but, like Richard Kuklinski, he could experience the physical pleasure of sex and enjoy gaining power over others. One thing no one yet knows is why LTK was a serial rapist but not a serial killer. Perhaps he would have devolved into one given time, or perhaps he would have continued to rape. What would he have become if the knife he used in his attacks had slipped?

Volunteer

All we know is that if he had used his knife to slice instead of coerce, he would still be a psychopath. His personal and criminal history more than qualified LTK to be a subject for an fMRI demonstration of emotional disability in the brain of a criminal psychopath. Specifically, the study he volunteered for investigated how his brain responded when asked to process information involving the recognition of emotions. Lying on his back, his head rested in the fMRI machine as he looked at images of line drawings depicting variations of happy, sad, angry, or neutral faces. The test also included faces in which the line-drawn features were scrambled like bad Picasso imitations drawn by a not particularly talented child. The scrambled versions obliterated any resemblance to a face or facial expression. A response button rested on LTK’s chest. Before the testing began, the researchers explained the rules of the testing procedure to him and he previewed the images so they would be familiar.

In the first phase of the experiment, he pressed the button like a game-show contestant when he saw a “target image,” one particular facial expression or scrambled facial image he had been asked to spot in a sequence. In the second phase, he was asked to press the button only when he recognized a target image that had appeared twice in a row. In the third phase, he was asked to press the button only when the target image appeared after it had shown up two images prior in the sequence. He did this for six conditions: three with images of facial expressions and three with scrambled faces. Only a third of the sequences required him to press the button to perform the task correctly. He looked at 18 presentations in each block of testing. Between testing sessions, he rested in the fMRI machine.

LTK’s brain scan results, like those of other psychopaths, were very different from those of the dozen non-psychopaths who served as controls for the study. For example, when LTK looked
at the facial expressions, 24 different regions of his brain were activated compared to only eight in the brains of the six men and six women of comparable age who served as non-psychopathic control subjects. Perhaps even more interesting is the fact that he seemed to process the information in evolutionarily older parts of his brain than did the controls. The non-psychopaths showed signs of activation not only in fewer brain regions but in more recently evolved regions of the neocortex.

LTK’s brain, by contrast, responded to the image-processing tasks by increasing blood flow to parts of the thalamus, insula, putamen, cingulate, and medial frontal gyrus on the left side of his brain, parts of the substantia nigra and caudate body on the right side, and the cerebellum.

The cerebellum—or “little brain” if you translate it from Latin—is located in the back of the skull and sits below the overhanging neocortex of the occipital lobe like a mollusk seeking shelter from the rain. For many decades it was associated with the control of fine movements, like those required for walking, learning dance moves, and fine motor tasks like rapidly and sequentially touching the tips of four fingers to the tip of the thumb on the same hand. Today it’s not surprising to page through neuroscience journals and come across reports linking this part of the brain with cognitive function and disorders that affect it. For example, some genes associated with autism influence the development of the cerebellum and others appear to be overexpressed in this part of the brain.
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Simon Baron-Cohen points out in his book The Science of Evil: On Empathy and the Origins of Cruelty that lack of empathy is a feature of autism, borderline personality disorder, narcissism, and psychopathy.

Why does LTK’s brain respond to the task of processing images of faces by activating older brain regions? Hoff and his fellow researchers speculate that LTK and other psychopaths do not use higher cognitive functions when analyzing facial expression. LTK’s brain, like that of other psychopaths who have taken part in similar experiments, seems to make use of more primitive mechanisms for processing information about facial expressions and emotions.

The authors of the LTK study remind us that LTK’s brain-imaging results are presented as a case study. Case studies are instructive and frequently interesting in a medical sense but may not apply to large populations. An essential criterion of useful scientific research is reproducibility. If no other
researchers working in independent labs can reproduce your results, then your results don’t amount to much until the discrepancy is resolved. This observation is often not stressed in popular accounts of research studies. But this does not mean that case studies like LTK’s are not important.

One valuable feature of LTK’s story is the extensive background information provided about him in combination with his brain-scanning results. More importantly, the results are consistent with those of other studies that correlate emotional disability with unusual neural responses. Repeated studies indicate that the ability of psychopaths to recognize and respond to emotional stimuli is impaired. Psychopaths, as we have seen, are also generally unmoved by anxiety-provoking situations that cause most people to squirm. It is one of the most important and noticeable features of the criminal psychopath. LTK, so different from 99 percent of the human race in terms of having a conscience, is much like his fellow criminal psychopaths in terms of having trouble processing emotions.

Another clue is provided by the way many psychopaths process language. Instead of processing it predominantly on one side of the brain—the left side in the case of right-handed people—many of them process or control language on both sides of their brains.
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This unusual lack of distribution of labor in the brain suggests that everything does not go according to schedule during brain development in these individuals, just as developmental problems are suspected in people who go on to develop schizophrenia.

Psychopaths also don’t do well on tests that rely on familiarity with abstract feelings. This may explain why complex emotions like remorse, compassion, love, guilt, and empathy are foreign to them and why they have to fake these feelings, mimicking the corresponding outward behavioral signs of these emotions when interacting with people, while all the while not actually feeling any of the emotions themselves. They don’t have problems relating to non-abstract feelings like hunger or sexual desire.

I Don’t Feel Your Pain

Another salient feature of psychopathy is lack of empathy; it is central to any description of this type of personality. You probably are not completely comfortable when thinking about closing a door on your finger. Just considering the prospect may make you uneasy, because past experience has
taught you that it hurts so much, it should never be repeated. Thanks to your sense of empathy, you feel the same way when you see someone else on the verge of having their finger crushed in a door. Empathy allows you to imagine the pain that person would feel when a finger is mangled.

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