If you have ever met a psychopath, you are already familiar with the fact that they are selfish, narcissistic, and violent. These antisocial personality traits have been confusing and offending the rest of us for so many years, so is there any explanation for this? And also, are these hardwired differences helping them or hindering their treatment?
There are some psychopaths who become killers while some of them turn out to be great businessmen, claim researchers. Psychopathy is basically a personality disorder. Although the Diagnostic and Statistical Manual of Mental Disorders (DSM) does not suggest that psychopathy is a standalone condition, it files it under the wider "antisocial personality disorder."
So then what exactly is a psychopath? What exactly makes for a person to be a psychopath? Back in 1993, Canadian psychologist Robert Hare, who is responsible for coming up with the famous Hare Psychopathy Checklist, has described psychopaths to be "social predators who charm, manipulate, and ruthlessly plow their way through life."
"Completely lacking in conscience and feeling for others," he further explains psychopaths as "selfishly take what they want and do as they please, violating social norms and expectations without the slightest sense of guilt or regret." This seems like a typical representation of psychopaths in media, for example, Hannibal Lecter, or serial killers Ted Bundy or Jeffrey Dahmer.
Many argue that there are many psychopaths that live among us. Recent research reports that 1 percent of non-institutionalized males in the United States are psychopaths. Even with this very meager percentage, psychopaths are 20–25 times more likely to be incarcerated than non-psychopaths, and the majority of the crimes committed in the U.S. are done by psychopaths.
After hearing about these statements, you must have thought about the possibility of your boss or neighbor being a psychopath right? Well, you could most definitely be right about this. In his book Snakes in Suits, Hare suggests that psychopaths are way more abundant that we may imagine. He claims that many psychopaths are there in the free world, doing good in the corporate world.
"[N]ot all psychopaths are killers," Hare describes. "They are more likely to be men and women you know who move through life with supreme self-confidence — but without a conscience." We hope through this article, that we may find the reason for some people being so conscious and remain confident. Can they be cured and is there a scientific explanation for their behavior?
"A marked lack of empathy is a hallmark characteristic of individuals with psychopathy," describes Jean Decety, a famous expert on the neuroscience of empathy. He is also an Irving B. Harris Professor in psychology and psychiatry at the University of Chicago in Illinois. He blames lack of empathy as being responsible for creating psychopaths.
The ventromedial prefrontal cortex shown above is the main point where we make our moral decisions. This image has been drawn by Patrick J. Lynch who is a medical illustrator. Many researchers have talked about a neural basis for empathy is either malfunctioning or missing altogether in the psychopathic brain. This what causes psychopaths to be so callous.
Experts claim that there is a problem with the mirror neuron system in psychopaths. These neurons in a healthy brain, are able to understand the actions and implications of others and ourselves when we do it. There is also a significantly less amount of gray matter in the brain's so-called paralimbic system — the conglomerate of brain regions which maintains self-control, emotions, placing goals, and being motivated during stressful times.
Just a few years back, Prof. Decety has done a few experiments and research on the psychopaths, finding out that simply do not have the neural "equipment" for empathy. With his team, he examined the brains of 121 inmates held in a U.S. medium-security prison during which they were exposed to painful situations. The study participants were also tested with the Hare Psychopathy Checklist-Revised (PCL-R).
If the subjects appeared to be"highly psychopathic" they were asked to assume them feeling the pain, parts of the brain linked to empathy did "light up" in the functional (MRI) machine like the anterior insula, the anterior midcingulate cortex, somatosensory cortex, and the right amygdala. But when they were asked to imagine this pain on other people, it did not light up.
It was also found that the participants' insulae and ventromedial prefrontal cortices (vMPFC) did not make a connection when asked to imagine another person's perspective. The vMPFC or the "social hub" of the human brain, is what makes the empathetic decisions which means it judges our actions and its effects on us and others altogether. Sadly psychopaths proved to have no human emotions when this test was run.
People have argued that psychopaths are not evil at heart but are just really bad decision makers. Joshua Buckholtz, an associate professor of psychology at Harvard University in Cambridge, MA, ran tests on 49 prison inmates where they were asked to choose between getting less money immediately or more money later. The ventral striatum which is a region in the brain became instantly very active in participants who appeared highly sociopathic on the PCR-L scale.
Low oxytocin sometimes results in low empathy according to researchers. This problem with having empathy may be correlated to low levels of "love hormone" and the role of the vMPFC in psychopathy. The vMPFC, narrates Buckholtz and his colleagues, is the controller of the reward-processing ventral striatum. In case we are offered $100,000 to kill someone, our vMPFC would inform the ventral striatum, "Hang on a minute! You may want to reassess that trade-off — is it really worth taking someone else's life for money? And can you bear the consequences of your actions?" But Buckholtz's research has discovered that the vMPFC and the ventral striatum are not interacting.
Buckholtz suggests, "The striatum assigns values to different actions without much temporal context. We need the prefrontal cortex to make prospective judgments [about] how an action will affect us in the future — 'If I do this, then this bad thing will happen.'" He explains, "[I]f you break that connection in anyone, they're going to start making bad choices because they won't have the information that would otherwise guide their decision-making to more adaptive ends. [Psychopaths are] not aliens, they're people who make bad decisions."
Most of the research work done by different researchers have all pointed to faulty brain circuits. So what is to blame for this issue in some areas of the brain? Many blame male sex hormone testosterone as the main reason. Prof. Karin Roelofs, at the Donders Institute at Radboud University in the Netherlands, did a study which proved that the amygdala and prefrontal cortex in the brain are not connected.
Most studies have in fact found that there are more psychopaths in males than females, so testosterone could be a very heavy factor. "Psychopathic individuals," the study claims, "are notorious for their controlled goal-directed aggressive behavior. Yet, during social challenges, they often show uncontrolled emotional behavior." Prof. Roelofs says this is a "paradoxical aspect of psychopathy." Researchers hope to prove that there is "a potential imbalance in testosterone function." So is it treatable?
If psychopathy is caused by neurons does that mean there is not a therapeutic way to reduce it or treat it? There has been proof in prisons that it can be rehabilitated. It has often been disputed that psychopaths have attentional deficits. If other mental disorders can be treated why can't psychopathy be treated? One huge difficulty is that psychopaths tend to be immune to any kind of punishment. The disconnection between the amygdala and the prefrontal cortex in their brain has left them emotionless.
The people working at the Mendota Juvenile Treatment Center (MJTC) in Madison, WI, have devised the so-called Decompression Model which is a cognitive-behavioral intervention which rewards any good deed, big or small. Their rewards vary and go from small stuff like getting dessert to video gaming privileges. This has definitely made a very positive impact on the participants.
The MJTC even let out a statement: "The program had the greatest impact on serious violent offenses, reducing the risk of their incidence by about half. Youth in the treatment group were more than [6] times less likely to engage in felony violence than the comparison group youth." Youth who did not get the MJTC treatment murdered 16 people while no homicide was committed by the ones in the intervention group. Lindsay Aleta Sewall who works at the University of Saskatchewan in Saskatoon, Canada claims that "a growing collection of studies has found that psychopathic offenders who decreased their risk as a result of treatment, demonstrate lower rates of recidivism."
Sewall makes a good point, stating that even if participants have a high score on the PCL-R psychopathy scale after treatment, it does not necessarily imply that the treatment was not fruitful. It is merely recidivism. The most important thing is to manage it rather than finding a cure. Prof. Buckholtz describes, "The same kind of short-sighted, impulsive decision-making that we see in psychopathic individuals has also been noted in compulsive overeaters and substance abusers." Let us hope with the proper treatment, a psychopath can one day lead a normal life.