Category Archives: Cognitive Neuroscience

Can anosognosia help explain some public acts of violence?

Anosognosia has been traditionally discussed when explaining why patients with Alzheimer’s disease (Perrotin et al., 2005), Schizophrenia (Gerretsen et al., 2015), and various lesions (Moro et al., 2016) have resulted in the patient lacking awareness of the functional deficits associated with their disease or affliction. There are two competing models to explain anosognosia; a psychological model, which claims the individual is protecting themselves from the stress caused by their disease, and a neurological model, which posits that the lack of the patient’s insight into their own disorder is due to a failure of neurocognition (Lehrer & Lorenz, 2014). However, both models are in agreement that it is the disease that results in anosognosia: The disease results in the patient not recognizing they have the disease – or at least some symptoms of the disease.

Researchers are still vying for a comprehensive neurological profile of this lack of awareness, and even though the diseases and the injuries that are associated with anosognosia are diverse, there is overlap in the parts of the brain that are impacted. Patients with anosognosia have been found to have hypometabolism in the posterior cingulate cortex (PCC) (Perrotin et al., 2015; Therriault et al., 2018; Vannini et al., 2017), hypometabolism in the hippocampus (Vannini et al., 2016), and reduced gray matter in the anterior cingulate cortex (Spalletta et al., 2014). Some studies posit that reduced right hemispheric volume, which could occur through disease atrophy or injury, relative to the left hemisphere, particularly of the angular gyrus, the medial prefrontal cortex, the dorsolateral prefrontal cortex, insula, and anterior temporal lobe, lead to a lack of awareness in schizophrenic patients (Gerretsen et al., 2014).

To date, there appears to be little research on the prospect of anosognosia concomitantly occurring with an empathy or a moral deficit. This is surprising for two reasons. First, the aforementioned brain regions listed above, are also known to be involved in moral decision making (Baron-Cohen, 2012) and empathic responses (Alegria et al., 2016). Second, it is sometimes symptomatic of patients with Alzheimer’s Disease (Liljegren et al., 2016) and Schizophrenia (Del Bene et al., 2016) to behave violently towards others, which means that any anosognosia could extend to a patient’s unawareness of their own harmful behavior.

THE IMPORTANCE OF EMPATHY IN MORAL DECISIONS

If an illness or a lesion results in both a loss of empathy or moral decision making, as well as the self-awareness of these, the behavioral intentions of the individual could change. This is extremely dangerous when the deficit is empathy, because empathy helps to inform humans about harmful behavior; if we observe another human in pain, most of us are able to recreate a sense or a feeling of that pain and thus feel that the behaviors and actions that have led to this are wrong. This mechanism can be behind our drive to prevent harmful behaviors and, and cause us to strive to ease the pain of others. If we stop or ease the pain of another individual, we prevent the need for an empathic response, and thus we stop or ease the empathic pain in ourselves.

The presence of an empathic response to seeing others in pain can thus lead to the stymieing of bad behaviors, not necessarily while they are being carried out, but even stopping them before they are carried out. The absence of an empathic response to pain could lead one to have the perception that some harmful behavior is okay, because this person is missing the internal response that would inform them otherwise. Our view of behaviors being right or wrong, due to our empathic response, will also shape our guiding philosophies and worldviews. If we feel that something is right or wrong, we tend to try and understand these feelings by providing a rationale, and this rationale contributes to our own moral code.

HOW ANOSOGNOSIA WITH AN EMPATHY DEFICIT COULD LEAD TO A DANGEROUS SHIFT IN IDEOLOGY OR WORLDVIEW

Anosognosia involving an empathy deficit could have a profound impact on the person’s life and their choices. Before the onset of anosognosia and the empathy deficit, the person might feel that certain behaviors are wrong, such as assault and violence; with empathy, these behaviors can be understood as deeply destructive, and function to prevent one engaging in them. The onset of anosognosia and an empathy deficit could lead to a person transitioning from feeling that a certain behavior is bad, to amoral or even good behavior.

Our sense of what is normal also informs our moral code and how we should treat others. Most people tend to think of themselves as rational and fair minded (even though some are open to considering the views of others), and so what they think as right or wrong about the world (including behavior) feels true because it has come from a balanced place. If a person was unaware that they had an empathy deficit, they would still consider themselves rational and fair minded, as they don’t recognize a deficit to undermine this view of themselves. This could mean as their moral code is subtly changing due to an absence of empathy, the change feels true, and thus right, further validating their new view of certain behaviors. If they attribute a recently adopted ideology to this shift in their view, the ideology, too, would be further validated.

A cursory glance at any number of manifestos, penned by murderers before they acted, will inform you of how the way they saw the world changed, and finally how this change brought on their actions, which they felt were necessary. A deliberate act of murder is clearly a failure of empathy, and one cannot help wondering if the murderer was even aware of their empathy deficit.

SOCIAL IMPLICATIONS OF ANOSOGNOSIA WITH AN EMPATHY DEFICIT

If an empathy deficit is observed in a patient, or individual, it is therefore of the utmost importance to understand if they recognize this deficit. A person who could understand that they have an empathy deficit, even if it’s temporal, could perhaps take measures to ensure they behave in an innocuous manner, through counseling, or through supervision by friends, family, or healthcare professionals.

It is also crucial to know if a person was aware of an empathy deficit before they acted destructively towards others, because it introduces accountability when the suspect is tried. In some cases of homicide, if mental illness, disorder, or mental illness is suspected, the prosecution often has to argue against a defense that claims the defendant was not accountable due to temporary or permanent insanity, or the defendant acted in a way that was out of their control, because of a clinical difference in brain or mental functioning. If it can be shown that the defendant was aware of their empathy deficit, the legal system could hold them accountable for their actions.

Jack Pemment © 2018

 

REFERENCES

Alegria, A. A., Radua, J., & Rubia, K. (2016). Meta-analysis of fMRI studies of disruptive behavior disorders. American Journal of Psychiatry, 173(11), 1119-1130.

Baron-Cohen, S. (2012). The science of evil: On empathy and the origins of cruelty. Basic books.

Del Bene, V. A., Foxe, J. J., Ross, L. A., Krakowski, M. I., Czobor, P., & De Sanctis, P. (2016). Neuroanatomical Abnormalities in Violent Individuals with and without a Diagnosis of Schizophrenia. PLoS one, 11(12), e0168100.

Gerretsen, P., Menon, M., Mamo, D. C., Fervaha, G., Remington, G., Pollock, B. G., & Graff-Guerrero, A. (2014). Impaired insight into illness and cognitive insight in schizophrenia spectrum disorders: resting state functional connectivity. Schizophrenia research, 160(1), 43-50.

Gerretsen, P., Menon, M., Chakravarty, M. M., Lerch, J. P., Mamo, D. C., Remington, G., … & Graff‐Guerrero, A. (2015). Illness denial in schizophrenia spectrum disorders. Human brain mapping, 36(1), 213-225.

Lehrer, D. S., & Lorenz, J. (2014). Anosognosia in schizophrenia: hidden in plain sight. Innovations in clinical neuroscience, 11(5-6), 10.

Liljegren, M., Naasan, G., Temlett, J., Perry, D. C., Rankin, K. P., Merrilees, J., … & Miller, B. L. (2015). Criminal behavior in frontotemporal dementia and Alzheimer disease. JAMA neurology, 72(3), 295-300.

Moro, V., Pernigo, S., Tsakiris, M., Avesani, R., Edelstyn, N. M., Jenkinson, P. M., & Fotopoulou, A. (2016). Motor versus body awareness: Voxel-based lesion analysis in anosognosia for hemiplegia and somatoparaphrenia following right hemisphere stroke. Cortex, 83, 62-77.

Perrotin, A., Desgranges, B., Landeau, B., Mézenge, F., La Joie, R., Egret, S., … & Chételat, G. (2015). Anosognosia in Alzheimer disease: Disconnection between memory and self‐related brain networks. Annals of neurology, 78(3), 477-486.

Spalletta, G., Piras, F., Piras, F., Sancesario, G., Iorio, M., Fratangeli, C., … & Orfei, M. D. (2014). Neuroanatomical correlates of awareness of illness in patients with amnestic mild cognitive impairment who will or will not convert to Alzheimer’s disease. cortex, 61, 183-195.

Therriault, J., Ng, K. P., Pascoal, T. A., Mathotaarachchi, S., Kang, M. S., Struyfs, H., … & Gauthier, S. (2018). Anosognosia predicts default mode network hypometabolism and clinical progression to dementia. Neurology, 90(11), e932-e939.

Vannini, P., Hanseeuw, B., Munro, C. E., Amariglio, R. E., Marshall, G. A., Rentz, D. M., … & Sperling, R. A. (2017). Anosognosia for memory deficits in mild cognitive impairment: Insight into the neural mechanism using functional and molecular imaging. NeuroImage: Clinical, 15, 408-414.

 

Manifesto: The relationship sociopaths have with themselves

ManifestoINTRODUCTION

Violent crime in the United States unfortunately remains a daily occurrence, and while domestic violence is undoubtedly the most common (and underreported), there now seems to be an increased interest in the role of ideology and murder. The recent shootings in San Bernadino, CA, and Philadelphia, PA, have been attributed to murderers who have been motivated by the ideology of the Islamic State of Iraq and the Levant (ISIL), and only in early October, 2015, Chris Harper Mercer killed nine people near Roseburg, Oregon, after penning his own manifesto that presumably explored his murderous inclinations. In 2014, Elliot Roger shot and killed six people and injured fourteen, after writing a manifesto entitled ‘My Twisted World: The Story of Elliot Roger.’

The motivations behind killing are complex and widely disputed, but it is time for some serious scholarship on the role that ideas play in dampening the conscience, at least temporarily, to provide an individual with a window of time where they have given themselves permission to kill. The role that ideology plays in the act of killing can be explained within the framework of sociopathy, but first this has to be distinguished from its estranged cousin, psychopathy.

 

PSYCHOPATHY

Psychopathy is noted as a mental disorder that is characterized by an emotional deficit and antisocial behavior [1]. Neuroscientists have found some profound differences in the brains of psychopaths when compared to the non-psychopathic, and these differences seem to result from developmental errors [2, 3]. Two key features of the psychopathic is the lack of empathy and remorse, and while many psychopaths are killers, a significant proportion of killers are psychopaths [4]. Psychopathy is also a clinical diagnosis, and so for somebody to truly be called a psychopath, they have to have been assessed by a professional mental health expert.

 

THE ROLE OF WORLDVIEWS AND IDEOLOGIES

When moving through our passage in life, we all develop a sense of what is right about the world, and figuring this out is probably one of the greatest sources of consternation many of us face on a daily basis. There seems to be a duality to this sense; feeling what is right, and then understanding conceptually what is right. When the two fit together, feeling right and being able to describe in words and ideas why we feel right, is an amazing and stable feeling, and the ideas are likely to become part of how we see the world. However, when our ideas and thoughts no longer feel right, or we feel right but do not know why, we are left feeling confused and perhaps even irritated.

Eventually, when we have had enough experiences and self-reflection, we start to develop a complex set of ideas that reflect what we think is true about the world.

During these pensive moments we suspend speculation and possibility surrounding the veracity of the idea, and it moves towards becoming a belief. This suspension could very well mark the difference between the scientific mind and the religious mind, as science only ever deals in probabilities, whereas the religious mind attributes absolute rightness to the core ideas, and this is known as faith (probabilities allow for‘wrongness’, a catalyst for the converse of faith, doubt). Indeed, always allowing a margin of error could mean that a person never has beliefs.

Regardless of how much truth currency we end up placing in our ideas, they become the mental lens that guides our behavior, gives us our sense of morality, and shapes how we will or will not understand the many more concepts and behaviors that will eventually cross our stream of consciousness. The new ideas and behaviors will be measured up against what we already have in our mental banks, and their acceptance into our worldviews will likely be a reflection of how well they agree with the rest of what we think is true about the world. Needless to say, this process can be excruciatingly hard work and can sometimes result in our peace of mind and sense of self being at stake.

 

PSYCHOPATHS AND IDEOLOGY

Our own personal worldviews and ideology tend to develop as we reflect on past experiences, contrast them with new ideas in the present, and then use ourworldview and ideology for perpetual self-reflection and interpreting new events as they arrive. From the case studies of psychopaths described by Cleckley [5] and Hare [4], psychopaths present as individuals who have little to no regard for their own future, let alone the futures of those they interact with. The psychopath appears stuck in the present, with an inability to make long term plans, and also has precious little regard for the past, and so it is questionable that a psychopath can develop a complex worldview.

Our worldview is also a reflection of our sense of morality. The ideas that we come to regard as good ways to live are built into how we see and interpret the world. Therefore, it stands to reason that if a psychopath has a limited sense of morality, any potential worldview or ideology is at an automatic deficit. When asked to justify their criminal behavior, many psychopaths will just admit that there was a rightness to it, mostly because they felt the dire urge to carry it out. The truth criteria behind their reasoning doesn’t fit into a complex philosophical framework, only that as
they felt they had to do it, it must have been the right thing to do.

 

SOCIOPATHY

The terms psychopath and sociopath are often used to describe the same type of person, that is an emotionless individual with a sense of grandeur and is prone to the manipulation of others, but the root words psycho and socio denote different developmental origins. As Hare notes [4], those who prefer the term sociopah tend to think that social forces and early experiences can explain this type of individual, whereas those preferring psychopath think that psychological, biological, and genetic factors offer the best explanation.

This polarized view of the etiology for psychopathy is terribly outdated, and falls victim to the old nature versus nurture discussion on the origin of behavior. Traditionally, a line seems to have been drawn at the skin of individuals, and everything on the inside reflects nature, anything on the outside is nurture, and they are mutually exclusive. While this framework perhaps provides a useful starting point for discussion, we now know that social influences and biology can interact together in very profound ways to influence the future path of an individual from the level of the cell all the way up to the organism. Our senses are lapping up so much information on a daily basis, and all of that information is creating changes in our biochemistry, especially in our nervous system. If a parent yells continually at their child, we may think, “Well, that’s terrible nurturing,” but it is also elevating the level of cortisol in the child’s circulatory system; soundwaves stimulating cells, sending signals that prompt tissues and organs to release molecules into the blood. All sensory stimulation leads to biological changes and activity, which is why this distinction between the two terms denoting etiological differences does not work.

Crucially, Hare and Babiak describe the sociopath as someone who has a sense of morality, but their sense of right and wrong has been informed by a subculture [6]. This
difference between the psychopath and the sociopath is profound, because unlike the psychopath, the conscience and the ability for rationalization in the sociopath are fully intact, which indicates an entirely different neurology. If sociopaths have an ideology, ideas of right and wrong, these ideas must be behind their eventual murderous behavior, and also goes a long way to explain the spree killer.

The term spree killer refers to an individual who is motivated, with varying extents of planning, to commit an act or acts of atrocity in a short space of time. One of the striking features about these types of events is that there is no attempt to hide or conceal the destruction or any associated fatalities or injuries. There is only the event, which must be completed, and often the only outcomes for the killer will be death by a shootout with law enforcement, death by suicide, death by sentence of the death penalty, or lifelong incarceration.

These outcomes provide some insight into the minds of these individuals leading up to and during the act of atrocity. It is inconceivable that at least the majority of these types of killers had no awareness of what would befall them after the event, which means at least one of two things. First, the act itself was valued by the killer more than their own life, and second, there was a physiological drive so powerful in their mind for completing the act that no other behavior was possible in the moment. The necessity of the act, which the killer could have justified to themselves many times, is heavily idea based, and because of this they were likely to have had a worldview containing ideas that devalued the lives of others.

 

THE GREATER GOOD

The idea of the ‘greater good’ is intriguing because when it is placed within an ideological framework that is supposed to promote the good or health of a group as a whole, it inevitably leads to the denial of the rights or even life of an individual or a subgroup of individuals. When the rights of people are often trampled upon for the greater good, the justification for this treatment is often seen as a necessary sacrifice, or once the new ideas or policies are in place, everyone will benefit (legislating common sense).

In order to implement a social or political system that is predicated upon greater good ideas, those with power have to be convinced, legitimately through debate or tacitly through violence. The style of the fight employed for the realization of these ideas is indicative of how well these ideas are to be received and the immediacy with which the advocate needs them to be realized. A potentially receptive audience and a debate reflect an advocate that is patient and willing to modify or compromise. A perceived unreceptive audience and violence reflect an advocate that feels compelled to act and is not willing to compromise. We can spot instances of these behaviors throughout history, particularly in terms of governmental behavior, but the desire for self-expression and the acceptance of ideas also operates on a much smaller scale.

For many, seeking acceptance among peers, or perhaps more potently in school, is a natural, but often painful, part of life. Finding a personal happy medium between what friends think is right and what you think is right is a daunting experience. To add to this, teenagers, by virtue of being young, do not have many other experiences with which to compare their immediate experience in school; this lack of experience in determining what is right for them results in grief and anxiety, and often puts them at the mercy of going along with a group that has met with their approval, even though there is sometimes respect for those who have the confidence to be different and not be influenced by the group, perhaps because it is such a huge pressure to overcome. The acceptance of ideas and behavior in these environments is similar to political expression at a higher social level, and could even be all the worse because of the huge emotional price tag of group acceptance. The perceived receptivity of the group and the compulsion for ideas and behaviors to be accepted could determine a change in tact of how an individual will later confront the group.

Even though many spree killers have no doubt accepted their own demise before they act, it is this notion that fuels their drive to act. They feel that their expression has been permanently blocked by those that need to validate these ideas (and related behavior), and so the only conceivable route of expression becomes violence to those who are blocking. This creates a fertile ground for accepting ideologies that dehumanize these ‘blockers.’ With resentment already in place towards those preventing self-expression, dehumanizing ideology towards these individuals will become palatable and sticky. This ideology, if unchecked, becomes the greater good for the individual in question.

Indeed, it could be useful to look at prejudicial worldviews in light of barriers to self-expression and a person’s right to the pursuit of happiness. Misogyny from men could result if men believe that women, by virtue of being women, will prevent their self-expression, especially sexual expression and subsequent gratification and acceptance. Likewise, Anti-Semitism results when an individual believes that Jews, by virtue of being Jewish, will always seek to prevent the self-expression and pursuit of happiness of non-Jews. At the heart of prejudice, there is always a lazy mind that is unwilling to evaluate people on an individual basis, as sweeping blanket condemnations seek to address painful and confused emotions. A lack of worldly experience, perhaps, would also prevent the person from having the cognitive maturity to make these individual assessments. It is worth asking, therefore, what is the object of the hatred preventing the subject from experiencing? When we have an answer to that question, it tells us all about how the subject thinks they should be able to exist in the world; behaviors they should be allowed to express, and ridding behaviors and ideas that muddy the waters of their idealized life. Knowing this could lead to methods of prevention or even intervention.

 

THE MANIFESTOS OF SOCIOPATHS

When reading a sociopath’s manifesto there are a few important points to note about the writing. The sociopath is usually presenting a history that supports the necessary action that will arrive by the end of the manuscript. As the sociopath’s mindset is heavily ruled by a guiding ideology, their main points or perceived milestones in their own development are likely to be heavily skewed or even fabricated.

However, much insight can be gained into their mind by realizing that the manuscript reflects back to them how they would like to be seen, perhaps not just by their community or the population after they carry out the devastating act, but also to themselves; the manuscript is how the sociopath would like to be seen in the mirror. Once the reflection pleases them, they are free to act.

The sociopath is likely to have spent months, maybe years, carefully crafting the manuscript and gone to painstaking detail to get it just right, and so this helps to combat the idea that they have intentionally gone out of their way to fabricate in order to trick readers. While this is still a possibility, the manuscript is usually a testament to what the sociopath believes is right about the world, after all, it provided them with the justification to act. While the history they present might not be objectively accurate, or perhaps even stunningly ignorant, the sociopath sees themselves ultimately as truthful and righteous, and no doubt want others to see them that way, too.

 

WHY WRITING CAN BE IMPORTANT TO THE SOCIOPATH

While not all manifestos are written, it is worth taking a long hard look at the ones that are. There is a very intimate relationship between an author and their writing, after all, writing is a way from them to organize and catalogue their own thoughts. The linguist, Noam Chomsky, is famous for noting that the majority of our language use is internal, and far exceeds our use of language in dialogue. Just take a moment to realize how frequently your thoughts are rolling through your mind, and how most of them drift in and out of a language, usually your primary one. Writing is the art of taking these ticker-tape thoughts and stabilizing them on the page, and the words can then be further manipulated until they meet with the satisfaction of the author, i.e. capturing (almost) perfectly the author’s intent.

For the confused or troubled mind, where thoughts and feelings are whizzing around like delocalized electrons, writing helps to pull them together into one place and provides the writer with focus. When an individual is experiencing emotional pain and confusion, therefore, this focus provides stability and a platform from which they can move forward. This is far from unique to the sociopath, and is most likely one of the main reasons that people keep diaries or write blogs. Writing facilitates clear thought, and clear thoughts, among other things, help to calm the mind and allow one to plan and project their future; goals can be determined and decisions made over the required behavior to meet those goals.

At some point in the life of the sociopath, the idea for committing an act of atrocity must enter their mind. The ease with which this idea is entertained will depend upon what they think is an accurate worldview (the right and wrong of the act), how necessary the action has become, and how compelled they feel to carry it through. This toxic idea will be stuck in their mind while they seek every justification for accepting it as more than just a good idea, but as something that they are compelled to act upon. During this time, there will likely be a high level of fantasizing and imagining, and an increased exposure to materials and ideas that facilitates the potential action in the mind of the sociopath; the act, slowly but surely, becomes inevitable.

The manifesto is a large part of making the act inevitable. It is worth bearing in mind that these acts are not a part of most people’s daily repertoire, including the soon-to-be-killer, and involve marathon amounts of planning and self-reflection. The sociopath needs to be able to see themselves actually doing the act, and there is very little room for doubt or uncertainty. This is why the manifesto is so important, because it allows the person to review and re-create their life history as if their life was always leading up to the deadly and devastating moment that they have decided is necessary. By cataloguing their history through the lens of their contemporary perturbed mind, therefore, right up until the present day, they are providing themselves with the consent and conviction that they need to go through with their plan.

This manufacturing of consent could also be why it is a good reason to stem the release of the manifesto after an act or at least hide many of the details surrounding the killer for as long as possible. If the manifesto was used as a tool to provide the author with consent to act, there is every chance it could be used by another individual with a similar history as a tool to act. If a like-mind is exposed to the manifesto soon after its author has acted, it could prompt the feeling of the immediacy to act again, perhaps resulting in a copy-cat killing. Silencing the thoughts and ideas of a killer after they have acted can only be effective for so long, but is still worth doing as a precautionary measure.

REFERENCES

1. Hare, R.D.; Harpur, T.J.; Hakstian, A.R.; Forth, A.E.; Hart, S.D.; Newman, J.P. (1990) The revised Psychopathy Checklist: Reliability and factor structure, Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2(3), 338-341

2. Raine, A.; Lencz, T.; Taylor, K.; Hellige, J. B.; Bihrle, S.; Lacasse, L.; Colletti, P. (2003). Corpus callosum abnormalities in psychopathic antisocial individuals, Archives of General Psychiatry, 60(11), 1134-1142

3. Raine, A.; Ishikawa, S. S.; Arce, E., Lencz; T.; Knuth, K. H.; Bihrle, S.; Colletti, P. (2004). Hippocampal structural asymmetry in unsuccessful psychopaths. Biological psychiatry, 55(2), 185-191

4. Hare, R.D. (1999) Without Conscience, New York, Guilford Press

5. Cleckley, H. (2015) The Mask of Sanity (3rd Ed.), Brattleboro, Echo Point Books and Media, LLC.

6. Hare, R.D. & Babiak, P. (2006) Snakes in Suits, New York, Harper Collins

The Onion in the Ointment: Neurodiversity With Psychopathy and Pedophilia

The formation of (and participation in) support groups to help individuals deal with unique medical or psychological conditions is a common occurrence in the United States. These groups help to build solidarity for individuals who once felt isolated, stories and anecdotes can be shared, and potential solutions or coping strategies can be imparted based upon similar experiences. These groups therefore provide an environment that is sensitive to the experiences and conditions that can stoke consternation and grief in everyday life.

Steve Silberman meticulously documented how the right group for those with autism can diminish the stresses experienced in a culture that has struggled to understand this neurodiversity. The number of support groups is endless, and they range from assisting victims of aggression, helping those suffering from debilitating and terminal illnesses, assisting those with neurological or psychological differences, and helping those who experienced extreme weather devastation. The point is that the support is there because there is a difference that majorities of people do not experience (or do not actively address), and this generates adaptation or standard of living concerns.

Technically, anything that meets this description generates the need of a support group, where measures can be addressed to help individuals onto a path that allows them to make the most of life, liberty, and the pursuit of happiness. From a mental health perspective, this is often accompanied by movements that push for culture to accept neurodiversity as personality differences, moving away from the stigmas of disorders.

However, there are at least two groups that by definition fall under the neurodiversity banner, which are problematic; psychopaths and pedophiles. While there is no unified neurological profile that can within an acceptable level of error capture all those that meet the diagnostic criteria for each condition, many studies have identified neurological differences; although, there is much diversity within psychopathy and within pedophilia, which make it hard to suggest unifying neurological differences, and behavior is diverse, too.

The behavior of both psychopaths and pedophiles can often be catastrophic, and could pose a serious threat to those who interact with them. For other neurodiverse conditions, individuals are taught to learn and structure their lives in a way that works with their set of differences; this clearly cannot be encouraged with psychopaths and pedophiles. In fact, if either of these groups wished to exercise their right for self-determination, as certain pedophile groups often have, society will push back. Support groups for pedophiles tend to focus on encouraging them to control their desires and drives, although the success rate remains questionable.

For psychopathy and pedophilia, therefore, neurodiversity is met with the need for resistance and legal protections that inhibit destructive and antisocial behavior which can result from their neurodiversity. This makes them unique from other neurodiverse conditions, and so therefore needs to be acknowledged and addressed in discussions that seek to encourage acceptance of neurodiversity. This may seem obvious, but arguments looking to support self determination based upon diversity need to be taken seriously, not in the least because there are exceptions.

While breaking stigmas remains a crucial battle, psychopathy, along with pedophilia, remain the elephants in the room.

Sources

Neurological study reviews focused on psychopathy

Anderson, N. E., & Kiehl, K. A. (2012) The psychopath magnetized: insights from brainimaging. Trends in cognitive sciences, 16(1), 52-60

Umbach, R., Berryessa, C. M., & Raine, A. (2015) Brain imaging research on psychopathy: Implications for punishment, prediction, and treatment in youth and adults. Journal of criminal justice, 43(4), 295-306

Weber, S., Habel, U., Amunts, K., & Schneider, F. (2008) Structural brain abnormalities in psychopaths—A review. Behavioral sciences & the law, 26(1), 7-28

Neurological study reviews focused on pedophilia

Fonteille, V., Cazala, F., Moulier, V., & Stoléru, S. (2012) Pedophilia: contribution of neurology and neuroimaging techniques. L’Encephale, 38(6), 496-503

Mohnke, S., Müller, S., Amelung, T., Krüger, T. H., Ponseti, J., Schiffer, B., … & Walter, H. (2014) Brain alterations in paedophilia: a critical review. Progress in neurobiology, 122, 1-23

Wiebking, C., & Northoff, G. (2013) Neuroimaging in pedophilia. Current psychiatry reports, 15(4), 1-9

Prayer and Imagination

PrayerA while ago I wrote a blog post called A Sense of Future and the Act of Killing, where I discussed how morality is tied up in our projections of the future. I want to play on this ‘sense of future’ idea, because I think it is integral to how we function as human beings. We spend a great deal of our time thinking about the future, and we don’t even realize it, especially when we’re thinking in terms of hours, days, or weeks. If we start thinking about months, years, or decades, thought becomes difficult and requires more time, energy and the supplementation of a hot or alcoholic beverage. And there’s a very obvious reason for this – the further into the future we want to project, the more we rely on our imagination.

In the short term, we know there’s a very good chance we will be finishing work at a certain hour, eating and drinking at some point, coming into contact with certain people, driving our cars, taking a certain route to work, etc. We also know there’s a slim chance some of these things might not happen (as has been our experience), but as we expect to do the same or similar things as the days before, there’s a good chance our immediate futures will reflect our immediate pasts.

So, as we use our imaginations to predict our future, we use our pasts as a kind of truth or likelihood gauge. Even when we expect something different to happen, we factor in our past experiences in order to prepare ourselves. For example, if you’re expecting a family member to visit tomorrow, there might be a few things you feel the need to prepare – stock up on food and beverages, be ready to discuss an important issue, and get rid of allergy inducing pet hair/feathers. From past experience we remember that the family member likes these foods and drinks, the important issue might require you to remember and think about past events, and from experience we know that a vacuum cleaner can get rid of pet debris.

One way that humans try to minimize apprehension of future events, especially when they believe there is nothing in their past experience that is any comfort, is to try and control the future. However, most of us realize that this is impossible, and so in the face of this problem we really try to ‘control’ ourselves, and we do this in at least three ways. Firstly, we deny the future event – we convince ourselves it is not going to happen, or not happen in the way that causes us apprehension. Secondly, we prepare as best we can by forecasting what we might need to know at the arrival of said event. Thirdly, we acknowledge that the future event could be a mixed bag of both good and bad things, thus minimizing our sense of doom. The strategy we choose will of course be influenced by our past experiences.

Prayer, in part, is an attempt to control the future. It is the expression of a desired outcome, usually one that the ‘prayer-ist’ has decided is the best (based on past experience). For example, praying for a sick relative. Sickness results in pain and grievance, experience with the relative while they were not sick was pleasurable, and we have forecast (based on past experience) that their death will cause many problems, both emotional and logistical. While expressing the desire for this outcome, we are imagining a future and planting these desirable ideas in our minds. When we do this, we have created a positive memory, which when recalled, allows for the re-experience of positive emotion. This lays the groundwork for hope. The rest of the prayer could involve a meditative element, or validation of the procedure – thanking the deity or genie in advance, and placating them in the time-honored traditions.

The efficacy of prayer is of course measured by the number of desires coming to pass AND accepting that if they don’t come to pass that the prayer was simply not in the best interest of the deity or genie. Where prayer is taught, one is also told that whatever the outcome, it is for the best. However, those whose prayers never seem to come to pass, will be faced with doubt and dissonance (their experience with prayer is not good). There is any easy way to improve your ratio of prayers that come to pass to those that do not, and it comes from the application of your imagination. Pray for things that you have a lot of experience with and for events that are in your immediate future. For example, pray that the Sun will rise and fall tomorrow, that you will eat and drink at some point, talk to your friends again, you’ll see cars and buses, you’ll receive a paycheck, or watch a movie soon – past experience dictates the extreme likelihood of all of these things, and will ease the burden of the abject failure of the big prayers – the ones that require a departure from past experience and are expected in the ‘unforeseeable’ future.

Dissecting Empathy: How Do Killers Experience Other People?

Dissecting empathyThe stereotype of a killer, especially a serial killer, is well known – a cold and remorseless man who usually plans and calculates his abductions and assaults, and has absolutely no empathy with his victims. The victim is not a person. They do not have hopes, dreams, and desires. They do not have family or friends who are going to miss them. They do not feel pain or suffering. They are a thing to fulfill the self-serving desires of the monster.

The topic of empathy in all humans (not just criminals) has been studied extensively, usually by taking ‘normal’ people and contrasting their biology and behavior with people we know have killed or committed cruel acts against another. In psychology, this line of questioning has led to diagnostic categories that are used to indicate a variety of disorders. For example, it is widely held that a lack of empathy is characteristic of a number of personality disorders – such as Antisocial Personality Disorder (APD), Narcissistic Personality Disorder (NPD), Borderline Personality Disorder (BPD). However, it must be noted that the lack of empathy experienced is not necessarily permanent, and may even be for only brief periods of time in very specific circumstances. Out of all three of the above mentioned personality disorders, APD is by far the most associated with serious crime.

Because of neuroscience, we now know that there are numerous ‘mirror’ neurons in the brain that become active in an individual when they both watch a task and perform the same task. This suggests that witnessing the behavior of others causes activation in our own brains similar to if we were doing the behavior ourselves. The argument is that perhaps we can ‘recreate’ the experience of others, which points to the presence of a neurological tool kit geared for this very purpose.

A recent study by Meffert et al. (2013) looked at brain activation in psychopaths when they were deliberately asked to empathize with individuals they saw in videos. One of the videos involved slapping another person’s hand with a ruler. When psychopaths observed this action there was low activation in the dorsal anterior cingulate cortex (dACC) (an area associated with pain), but when asked to empathize, the activity in the area increased when viewing the same video. Another aspect of the experiment involved the psychopaths actually getting hit in the hand with a ruler, similar to the video, and there was no difference in activation between the psychopaths and the non-psychopaths. This means that the dACC was active in the psychopaths when experiencing the slap. The study suggests that the mere act of asking the psychopaths to empathize, literally did ‘flick on’ their ability to empathize with pain.

Could a victim of a psychopathic killer or rapist simply ask their attacker to empathize with their pain? Probably not. Passively watching a video of a non-sexual and relatively innocuous act seems to be necessary for it to work, and we have to remember that empathy with no action does not stop criminal behavior. This is not to undermine the above study, because showing that empathy can exist in psychopaths is a major finding. I would also like to know what would happen if the normal group in this study were asked to not empathize or at least fabricate irrational reasons why they hate the person getting hit by the ruler. Would we see something as devastating as the Stanford Prison Experiment?

So, empathizing with victims is clearly compromised in the mind of a killer, but what about empathizing with partners in crime? I bring this up because I think it adds another layer of complexity as to why people kill. Most serial killers act alone (Bundy, Dahmer, Gacy, Sowell, Keyes, etc.), but there are some infamous partnerships and groups who are also responsible for multiple murders. The D.C. Sniper (John Allen Mohammed), who terrorized Washington D.C. in early October 2002, had an accomplice – Lee Boyd Malvo. Mohammed had become a father-figure to Malvo after they met, and despite being separated numerous times, Malvo always sought out Mohammed. Malvo had only been fifteen when the two met the first time. After the two were arrested, Malvo did later testify that Mohammed had pulled the trigger ten times, and himself three times (Censer, 2010).

Clearly, there was a relationship between Mohammed and Malvo.  I do not think it is a stretch to say that Malvo loved Mohammed, as evidenced by his willingness to imprint on the former U.S. soldier. Mohammed had very strong anti-U.S. views and even went so far as to say that the U.S. deserved the terrorist attack on 11th September, 2001 (Censer, 2010). Mohammed’s views no doubt rubbed off on Malvo, who was receptive to them because he loved his father-figure. In a child-parent bond, it is love that helps provide our truth criterion for the world. Parents are imitated by their children, in part because the child loves them (they would be less inclined to imitate people they have taken an active dislike to). The activities of the parent are therefore recreated and performed in the brains of the children – this means that the child can and will now empathize with the parent. Malvo imprinted on a killer.

Mohammed may have loved Malvo as a son or a protégé, but Malvo is not the reason he became a killer. Mohammed had killed in the army, felt betrayed by the U.S., and developed strong radical Islamic beliefs that preached the U.S. to be the enemy. The choice to kill civilians is lost within those facts and we do not know if he had any pathology that led him down the road to murder (i.e. psychopathy).

Linda Kasabian, Patrica Krenwinkel, and Susan Atkins also imprinted on a dangerous man. Through the use of drugs, role playing and open sex, Charles Manson slowly but surely began to control the minds of these young women when he met up with them in California in the 1960s. Manson was eventually able to talk these women into the mindset of murder. He had become their leader and they would do anything for him. Like Mohammed, Manson had very strong beliefs about the world, particularly that a war between black people and white people was inevitable. Through the relationship that these women established with Manson, he was able to persuade them to share a similar outlook.

I have argued elsewhere that we need to treat the terms ‘psychopathy’ and ‘sociopathy’ differently (Pemment, 2013). One reason I give for this is that sociopaths do have a sense of morality (Hare & Babiek, 2010) and as such their brains are likely to function differently than the psychopath. The need for this distinction can also be seen in the light of these examples. A strong relationship with a criminal mind can facilitate the acceptance of criminal behaviors and the adherence to dangerous ideas. This happens because of empathy. A sense of morality is still present, only it allows for circumstances that devalue life. A sociopath, therefore, must be capable of empathy for a cause or an ideology (or a person who represents them), so they can ironically prevent themselves from empathizing with those this ideology devalues. A psychopath, as we have seen, has a diminished capacity for empathy that results from their brain not developing correctly. Psychopaths, by extension, do not tend to have a sense of morality.

In law, when considering murder, the concept of guilty mind (mens rea) and guilty body (actus reus) are often considered, and I also think these concepts can be used to discuss psychopathic and sociopathic killers. Dahmer was a psychopath and tortured and killed animals as a teenager and later had uncontrollable urges to drug and kidnap other men, rape them, and carryout unspeakable acts with the bodies. In an interview with Stone Phillips, Dahmer discussed how he wanted complete sexual control over the men he abducted, and this was not explainable, other than he just felt the compulsion to commit these acts. The detective (Keppel) who helped bring the psychopath Ted Bundy to justice, once interviewed Bundy, and Bundy explained his need for necrophilia like a chemical tidal wave – like the sudden need for a narcotic. These needs do not reflect a morality or a worldview consisting of many interlocking and self-supporting ideas.  Mohammed’s anti-US Islamic ideas, Manson’s race wars, and I would argue Anders Breivik’s National Socialism, do.

There has been a lot of debate surrounding psychopathic serial killers and whether or not they can be held accountable, especially if they have a unique brain. If we consider the mind as the part of the brain responsible for our intellectual life and our worldview, then this is not the part of the brain that motivates psychopathic killers to kill – therefore they would have actus reus, but not mens rea. Sociopathic killers, by contrast, would have at least mens rea, and possibly actus reus. Psychopathic killers have to have a guilty body because the physical interaction with their victim is everything to them – and this interaction usually results in their victim’s death. But to have a guilty mind in the context of murder, one must have a capacity for empathy.

© Jack Pemment, 2013

Sources

Censer, J. R. (2010) On the Trail of the D.C. Sniper: Fear and the Media, University of Virginia Press

Hare, R; Babiak, P. (2006) Snakes in Suits, Harper, New York

Meffert, H.; Gazzola, V.; den Boer, J. A.; Bartels, A. A.; Keysers, C. (2013) Reduced Spontaneous But Relatively Normal Deliberate Vicarious Representations in Psychopathy, Brain, 136, 2250-2562

Pemment, J. (2013) Psychopathy Versus Sociopathy: Why the Distinction Has Become Crucial, Aggression and Violent Behavior (in press)

Psychopathy vs. Sociopathy

Psycho SocioI was happy to land my second review paper in the journal Aggression and Violent Behavior. Quibbling over terminology is not uncommon in any field, but I make the case that these two terms have to be treated separately. Robert Hare, the designer of the the Psychopathy Checklist (PCL), and Paul Babiak, state in their book Snakes in Suits that sociopaths differ from psychopaths in that they do have a sense of morality, although it’s a sense derived from a subculture (rather than the over-arching parent culture). The presence of a sense of morality means that the brain of the sociopath is likely to be different from the brain of the psychopath, or the characteristics that define both represent different brain systems – perhaps with some overlap.

Pemment, J. (2013) Psychopathy versus Sociopathy: Why the distinction has become crucial, Aggression and Violent Behavior (In press)

Abstract

The terms psychopath and sociopath are often used interchangeably, but there appears to be some hesitance by researchers in the many disciplines comprising criminology to continue this trend. The problem seems to be that as research has advanced in studies of psychopathy, which is the more common of the two terms, psychopathy now commands a much more specific definition, and this is what alienates it from its estranged cousin, sociopathy. As language can serve to hinder or confound research, it is crucial that these terms take their proper place in brain science. Here, I present how the two terms are currently used in neuroscience and psychology, and suggest how research in sociopathy should progress.

The Role of Ring Girls at Professional Fighting Events

I am a boxing fan, and I do enjoy some of the promotional theatrics before professional sporting events between boxers. But what really sells the fight for me is the opportunity to watch two highly trained and highly skilled athletes box in the ring. Ring girls have always been there, and usually you just see an attractive and sometimes mostly-naked woman walking around in between rounds to let the crowd know which round is about to begin. It’s obviously all about sex appeal and something to press the deep evolutionary buttons within male audience members to give them a temporary buzz and make them feel like the event was worth the price of admission.

And that is the only point of ring girls. Carrying cards to indicate forthcoming-rounds is the epitome of a sinecure job. Obviously, ring girls are not the only example of using sex and naked women to enhance and promote events and products, and maybe there is an argument that being a ring girl helps to promote modeling careers of the women involved. While I am ashamedly on the fence with a number of these issues, what worries me is the presence of representations of sex and aggression in the same place.

Something that should strike us all as obvious, at least in the male, is that the brain can be warmed to sex and to aggression at the same time, meaning that they are not as conflicting emotions as one might think. This does not necessarily mean one is emphatically horny and dangerously aggressive at the same time, but the general buzz of both emotions can effortlessly sit in the slightly excited body of the spectator. Perhaps both of these feelings together represent a state of mind and brain that makes one feel like an alpha male – a firing of all the cylinders in the ‘machismo’ circuit, which helps boost the ego and makes one feel alive.

Areas of the brain have been explored in men that become increasingly active during exposure to aversive/aggressive circumstances, and during exposure to sexual/erotic imagery. These tests are obviously controlled, so any activation is limited by precisely what the participant was exposed to, and the increased activation of certain brain regions must not be interpreted as these are the sole areas specifically involved in these activities. A point to note, however, is that a number of the same or similar areas are involved in both perceiving and feeling aggression, as perceiving and feeling arousal. Hopefully, one day we’ll see a study that monitors changes in activity from aggressive stimuli to arousing stimuli; my guess is that there might be one or two key differences, but the rest would remain subtle and barely noticeable. While this study would not tell you about the individual’s conscious experience through this shift, it might tell you just how lazy the brain can be when the context changes. This laziness could perhaps indicate how easy it is to shift from the aggressive state to the erotic state, and vice-versa.

But back to ring girls. While I am not going to argue for the complete removal of the girls from the sport of boxing, or indeed from other professional fighting events, I wholeheartedly argue that they be more clothed. One reason for this is that if ring girls are mostly naked, it creates the expectation that they be mostly naked all the time – the expected buzz attached to the price of admission. A model in an evening gown can still arouse the brain, but to the point of a subtle appreciation of her beauty, after all, spectators should be there to watch the boxing match. There are other places to go or websites to visit if anything else is desired.

There is a ‘ring girl’ culture growing in the United States, mainly in the Ultimate Fighting Championship (UFC) and other Mixed Martial Arts (MMA) events. Ring girls have televised try-outs and have to pose in outfits that would make normal underwear blush. In fact, it almost appears that MMA ring girls are vying to compete with Playboy (indeed some MMA ring girls have been in Playboy). This is no doubt a marketing ploy of MMA promoters in order for them to create a strong brand and maximize their franchising, on top of promoting their fights. The continual rise of MMA is going to be interesting to watch, because fighters are permitted to be fairly brutal to each other, showing maximal levels of aggression, and the associated ring girls are flaunting maximal levels of sex appeal.

In terms of appealing to the young male mind, the trap has been set.

References

Ferretti, A., Caulo, M., Del Gratta, C., Di Matteo, R., Merla, A., Montorsi, F., … & Romani, G. L. (2005). Dynamics of male sexual arousal: distinct components of brain activation revealed by fMRI. Neuroimage, 26(4), 1086-1096.

Lotze, M., Veit, R., Anders, S., & Birbaumer, N. (2007). Evidence for a different role of the ventral and dorsal medial prefrontal cortex for social reactive aggression: An interactive fMRI study. Neuroimage, 34(1), 470-478.