The Psychopath Whisperer: The Science of Those Without Conscience (6 page)

“Back to work,” I told Dorothy.

“Back to work,” she echoed.

I headed down the sex offender tier for the first time. I passed by the cells until I read Gary’s name on the cell door.

“Gary,” I said, peering into a dark cell. He had pictures of hockey and football players on his cell walls.

“Figured I’d hear from you at some point” came the answer out of the darkness.

Gary emerged from the recesses of his cell and came to the door.

He was a big man. I couldn’t help but notice the muscles bulging out from under his white T-shirt. I was thankful that we did not end up in an altercation.

“So you gonna do this research stuff or not?” I asked.

Laughing, he replied, “Sure. That’s all you want to say to me?”

“We can talk about stuff once you’ve signed all the consent forms and the confidentiality documents,” I said.

“So I don’t have confidentiality yet,” he said in a nervous tone.

“Nope, not unless you sign up for research,” I said, realizing that I might be manipulating a research subject into participating.
Oh, well
, I thought,
the ethics board would understand
.

“Okay. Why not? Guys around here say you’re fun to talk to,” he replied.

“Sign this form—it allows me to check out your files—then I’ll come get you after lunch today for your interview.”

“No problem,” he said. “But it might take you longer than that if you are going to read
all
of my file.” He laughed and sat down on his bed.

“Well, two p.m., I’ll come get you.”

I walked out of the tier and straight down to the file room, requesting Gary’s file.

Normally, the clerk would return with a folder or two, about two to four inches thick. The files contain police reports, institutional behavior reports, social worker histories, interviews with other mental health personnel, family and work histories, school records, and such. In this case, the clerk returned with a six-inch-thick file, bound together with several thick rubber bands.
That’s not so bad
, I thought, picking up the file. Then the clerk said, “Hold on, that’s just the first folder.” She called back, “You want this in a box or do you want to try and carry it?”

“Umm, box, please,” I said. Gary’s file filled a copypaper box. He was right; it would take me more than a lunch hour to read his file.

It turned out to be one of the most amazing case histories I would ever read. Gary would become my first perfect score—a 40 out of 40 on the Psychopathy Checklist, one of only a handful that I would find in the next twenty years.

Gary also became the very first psychopath to participate in brain scans a few years later.

After passing Gary and Grant’s charade, the inmates accepted me into their circle. They signed up en masse to participate in research. During my seven-year tenure at RHC, over 95 percent of inmates volunteered for research. And so my career was under way, interviewing hundreds of inmates, cataloging their life histories, assessing their symptoms and personality traits, and eventually, studying their brains.

In 2008, author John Seabrook of
The New Yorker
wrote
a feature article about my laboratory with the title “Suffering Souls.”
²
As part of his research prior to writing the story, John visited my lab several times and had a tour of one of the New Mexico prisons where my team and I conduct research. At the outset, Seabrook didn’t know the historical research that has been conducted on the psychopath, instead relying heavily on the way psychopaths are portrayed in popular film and media. Seabrook and I spent several weeks discussing the history of psychopathy, and he wove a wonderful story capturing the status and controversies of the field at the time.

As I told Seabrook, a little less than 1 percent of the general population, or about 1 in 150 people, will meet criteria for psychopathy. However, the number of psychopaths in prison is much higher than in the community because psychopaths tend to get themselves in trouble with the law. Studies indicate 15 to 35 percent of inmates worldwide will meet criteria for psychopathy—with more psychopaths being found in prisons with higher security ratings. I told Seabrook that something
special
seems to happen when the majority of psychopathic traits coalesce in the same person. I’ve often been quoted as saying that there is “just something different” about psychopaths.

Nevertheless, it’s important to recognize that psychopathic traits exist, more or less, in all of us. Fortunately, the distribution of psychopathic traits is skewed
—most
people have very low levels of the traits,
some
people have a bit more of the traits, and only a
few
people have high levels of the majority of the traits. It’s the last group that scientists reserve for the diagnosis of
psychopath
.

But the term
psychopath
continues to be (mis)used in a wide variety of contexts. For example, it is not uncommon for the media to declare that a Wall Street trader, politician, or deadbeat dad is a
psychopath
. In this context the media are typically using the label
psychopath
as a derogatory term, and they are not referring to the scientific definition of the disorder. When I am asked about such offending politicians, I typically reply that such individuals may be a bit
more
psychopathic than the rest of us, but I prefer to leave the diagnoses of
psychopath
for those few among us who have the full manifestation of the disorder.

Let’s examine how history has recorded those among us who are “just different” from the rest of us.

Like Seabrook, I have borrowed the “Suffering Souls” chapter title from German psychiatrist J. L. A. Koch (1841–1908), who is credited with coining the term
psychopastiche
, or
psychopath
.
³
The term literally means “suffering soul.”

Psychopaths, under a different label or terminology, captivated attention long before Koch. Indeed, since humans first evolved, history has recorded stories of humans who display what we now understand to be the disorder psychopathy.

Perhaps the earliest written description of psychopathic traits can be found in the Book of Deuteronomy about 700 BCE.
⁴
About three hundred years later, one of Aristotle’s students, Theophrastus (371–287 BCE), became the first scholar to write about psychopaths in any detail. He named his prototypical psychopath “the Unscrupulous Man.”
⁵

Stories of psychopaths pervade literature. Greek and Roman
mythology is strewn with descriptions of such characters. Accounts populate the Bible, beginning with Cain—the first murderer. Psychopaths have appeared in stories from all cultures: from Shakespeare, including Richard III and Aaron the Moor in
Titus Andronicus
, to the villain Ximen Qing in the seventeeth-century Chinese epic
Jin Ping Mei
(
The Plum in the Golden Vase
). More recently we have Macheath from Bertolt Brecht’s
Threepenny Opera
and Hannibal Lecter from Thomas Harris’s book
The Silence of the Lambs
.

Psychopaths also appear in existing preindustrial societies, suggesting they are not a cultural artifact of the demands of advancing civilization but have been with us since our emergence as a species. The Yorubas, a tribe indigenous to southwestern Nigeria, call their psychopaths
arana-kan
, which they describe as meaning “a person who always goes his own way regardless of others, who is uncooperative, full of malice, and bullheaded.”
⁶
Inuits have a word,
kunlangeta
, that they use to describe someone whose “mind knows what to do but he does not do it,” and who repeatedly lies, steals, cheats, and rapes.
⁷

Psychopaths are typically described in historical texts as monsters, evildoers, people who lack the emotional connections that bind the majority of us, as well as the inhibitions that those connections engage. Simply put, psychopaths lack conscience and empathy.

Psychiatrists, like the rest of us, have also been fascinated with psychopaths. Clinicians have written about psychopaths since the birth of psychiatry in the early 1800s.

The first psychiatrist to write about the condition was the director of the most famous insane asylum in the world, the Bicêtre Hospital, just outside Paris, France. Philippe Pinel (1745–1826), the founding father of modern psychiatry, described a group of patients afflicted with
mania sans délire
(insanity without delirium).
⁸
The term was used to describe cases of individuals who had no intellectual problems but a profound deficit in behavior typified by marked
cruelty, antisocial acts, alcohol and drug use, irresponsibility, and immorality.

What struck Pinel was that the intelligence of these individuals was generally very high, but something was not right with them. Pinel had been trained to view the mentally ill as only those who had delusions or distorted awareness. But as he discovered more and more of the latter patients who suffered from a severe deficit in morality, he changed his views. Pinel was one of the first to describe a type of
insanity
that did not occur with a commensurate confusion of mind and intellect, differentiating these cases from patients with psychotic behaviors.

It is important to understand that psychotic patients (i.e., psychosis) and psychopathy are very different. Psychosis is a fragmentation of the mind, leading to symptoms that include hallucinations, delusions, and disordered thoughts. A critically acclaimed movie illustrating psychotic symptoms is
A Beautiful Mind
, in which actor Russell Crowe portrays Nobel Prize–winning mathematician John Nash. Nash suffered from hallucinations and delusions but was still able to develop game theory that revolutionized the field of economics. Psychosis is manifest in disorders like schizophrenia, bipolar disorder, and major depression. These psychotic symptoms are not typically observed in psychopaths.
⁹
Indeed, it was the absence of psychotic symptoms that originally differentiated psychopaths from other patients in mental hospitals.

Echoing Pinel, the American psychiatrist Benjamin Rush (1745–1813) argued that the moral faculty, like the faculty of intelligence, was susceptible to brain damage and should be included in the realm of medicine.
¹⁰

As the United States developed its legal system, the notion of free will and responsibility took center stage as psychiatrists began to describe more and more mental illnesses that were associated with impairments that might lead to insanity defenses for criminal behaviors. From the beginning, psychiatry and law have had a tumultuous relationship. This tension was never more evident than in the development of the condition “moral insanity” first proposed by James Prichard (1786–1848).
¹¹
Prichard’s use of the term
moral insanity
was broad and encompassed nearly all mental illnesses except for schizophrenia and mental retardation. In the 1800s, the concept of moral insanity led to a lively debate in psychiatry in the United States.

Across the pond, a supporter of Prichard, leading British psychiatrist Henry Maudsley (1835–1918), stated in 1875 that:

Prominent supporters of moral insanity, such as Isaac Ray (1807–1881), argued that the emotional and intellectual psyches were of equal importance with respect to the definition of
insanity
. Ray believed that behavior emanated solely from the brain and that aberrations of emotional powers were connected with abnormal conditions of the brain.
¹³

The concept of moral insanity and its subsequent related brethren thus set out on a long and complicated history with the legal system. On the one hand, psychiatrists argued that patients afflicted with psychopathic symptoms were as disordered as patients with schizophrenia; on the other hand, many people had serious concerns with what was essentially the medicalization of criminal behavior.

Moral insanity continued to be debated in legal and academic circles as books and other publications proliferated arguing one side or the other. In part because of the controversy of the term
moral insanity
and because of the generality of the term as it applied to many who were simply criminal, German psychiatrist J. L. A. Koch (1841–1908) coined the term
psychopastiche
, or
psychopath
, in 1888.