Category Archives: Morality

A simple math problem? Stopping school shootings

Dan Patrick

Dan Patrick: Lt. Gov. from Texas (R) GETTY IMAGES

The manner in which our represented officials approach school shootings can be absolutely mind boggling.

Speaking about the recent shooting at a Santa Fe High School, Dan Patrick, a Lieutenant Governor from TX, commented that “four or five guns to one” was the best way to stop a gunman. The logic behind such thinking should immediately disqualify him from representing the public.

This idea of increased numbers suggests that some kind of arms race is necessary to keep ahead of these evil people who come out of the woodwork from time to time. Is there an ideal ratio? How about ten guns to one? For what is undoubtedly a complex social problem, are we really willing to rely on a ‘more is better’ approach? Is that the best that our elected officials can manage?

There is also something deeply unsettling in that a ‘more is better’ would clearly drive profit margins for the very tools that were used to commit the atrocity. When tragedy becomes lucrative it should make any rational person ask for greater transparency, especially between the industry and our elected officials. What would we make of an increased sale of crowbars, related to how well Ted Bundy used them?

I don’t necessarily think that officials like Patrick are ill-intentioned, but there is clearly something about the gun that appears to be “morally cleaner” than a crowbar. The NRA has often touted that “the only way to stop a bad guy with a gun is a good guy with a gun,” but would we feel the same if the adage was, “the only way to stop a bad guy with a crowbar is a good guy with a crowbar”? You can substitute “gun” with any other noun to realize that there is clearly something very special about the “gun” in American society.

The showdown, at High Noon, where the good guy finally triumphs over evil, perhaps?

Is this romantic idea what is polluting the minds of our aging white male public representatives? The gun clearly provides the luxury of being impersonal, which provides the illusion that shooting someone is morally cleaner than swinging a crowbar into their head.

Substitute gun for crowbar and morally speaking you start to realize there isn’t really a good guy with a crowbar. It can start to seem acceptable in the context of self-defense, perhaps, but even if it can be shown to have been necessary for a person to smash an unconscionable aggressor in the face with a crowbar to stop them doing something terrible, nobody is ever going to feel normal again afterwards, even with the solace that the tragic event was interrupted or prevented. This is the kind of stuff that has driven our veterans and police to the edge of their sanity, and they were trained to deal with situations such as this.

The ‘more is better’ approach also misses one crucial point about spree and school shootings: The perpetrators do not care if they lose their own life, and they have already accepted this. It is common that the shooter will shot by police, or they will shoot themselves at a key moment not long after they began the shooting.

This psychology makes them just as dangerous as suicide bombers, and also undermines the argument that ‘more is better’ is somehow a deterrent to these shooters.

It is highly unlikely that even a “trained” civilian cares if they themselves die in the exchange; they may be willing to sacrifice themselves for others, but that is not the same thing. By wanting more guns in school, you’re not just requesting more gun carriers, you are requesting people who are openly willing to kill another person.

How rigorous does the training have to be to prepare somebody for this event scenario? There is a reason psychological testing is crucial for the police and our military. When you ask a person to be prepared to kill another, you are asking them to be prepared to circumvent their own conscience and live out the rest of their lives knowing what they have done. There is a personal cost to killing another person, and the only people who do not pay this cost, are those without a conscience – and I think we can agree that we do not want these people in our schools.

I think what has changed, with the increased level of awe-inspiring activism, is that people are beginning to realize that these events are much more than the shooting – a young loner, walking into a school, and shooting others. Political inaction is simply not good enough, anymore, and simple responses are offensive. It is high time we stop romanticizing over easy and poorly thought out solutions. Polarizing the world into good and bad is not productive and it does not result in a pragmatic approach to solving this problem.

Anyone who would have you believe otherwise, does not represent you.

Manifesto: The relationship sociopaths have with themselves


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 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.



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.



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.



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 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.



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.



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.


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

Anosognosia, Psychopathy, and the Conscience

How people see and understand themselves is likely to have an impact on how they interpret interactions with others. Here, I briefly explore the brain areas implicated in anosognosia, how these areas are also relevant in psychopathy, and why anosognosia is important when considering the crime and the conscience.


Anosognosia is defined as the impaired ability of patients with neurological disorders to recognize the presence or adequately appreciate the severity of their deficits [1]. Torrey (2012) cites three examples of anosognosic patients; a stroke victim with a paralyzed arm claimed he couldn’t lift it because he had a shirt on; a woman with paralysis in her left arm was asked to raise it, and instead raised her left leg. When this was pointed out to her she responded that some people call it an arm, others a leg, and jokingly inquired as to the difference; the Supreme Court Justice, William Douglas, was paralyzed on his left side. He claimed this was a myth, and was still inviting people to go hiking [2].


Recent research on this phenomenon has identified deficits in the brain of the patients who in all honesty do not recognize that they are in some way impaired. By using fluorodeoxyglucose positron emission tomography (FDG-PET) and single photon emission computed Tomography (SPECT) Perrotin et al. (2015) found that anosognosic Alzheimer’s patients had a disruption in connectivity between the posterior cingulate cortex (PCC) and the orbitofrontal cortex (OFC) [1]. Ries et al. (2007) also implicated a compromised precuneus in anosognosic patients. These midline structures are susceptible to damage in those with Alzheimer’s Disease (AD) and stroke victims. Anosognosia is also experienced by schizophrenic patients; according to Gerretsen et al. (2015), 60% of schizophrenic patients experience moderate to severe illness awareness, and this can lead to medication non-adherence and poor treatment outcomes [4]; they found left hemispheric dominance in the left prefrontal cortex in anosognosic schizophrenic patients and cortical thinning in the temporoparietalocciptal junction (TPO).

There is still much work to be done to determine the mechanistic and functional basis of anosognosia, and to determine the subtleties between illnesses and disorders, but research is starting to identify suspect brain regions. This is useful if anosognosia is questioned in other disorders, because neurological studies exploring the disorder can be explored and legitimate avenues of scientific inquiry explored.


A failure to recognize a disorder is also present in those with psychopathy. While anosognosia is yet to be explored thoroughly in those with psychopathy, there are behavioral items on the Psychopathy Checklist (PCL-R) [5] that suggest anosognosia is present; grandiose sense of self-worth, lack of remorse, and failure to accept responsibility. The sense of self-worth and narcissistic traits of the psychopath clearly means that they think very highly of themselves. This negates the idea that the psychopath believes they suffer from a defect or a disorder; at the most they might recognize that most others are different, and perhaps inferior to themselves. If a lack of remorse is experienced, this is an explicit demonstration that they do recognize, at least on an emotional level, the consequences of their bad behavior as being wrong; if they do not believe their behavior is inappropriate, it stands to reason that they believe they behaved appropriately, and thus experience nothing ‘wrong’ about themselves. This aspect of self-belief and self-reflection is also seen in the psychopath’s failure to accept responsibility; if they are always good and right, there is little motivation to make amends.

Based upon this cursory examination of psychopathic behavior, it would seem reasonable to explore the neurological studies of psychopathy and see if there could be some overlap with previous studies on anosognosia, and in fact some of the same compromised brain areas are implicated. Many studies have demonstrated developmental differences in the PFC of the psychopath (for a review, see Umbach et al. (2015) [6]), and the white matter pathways, such as the uncinate fasciculus (UF) connecting to the PFC from the limbic regions [7]. Perrotin et al. [1] hypothesized that Anosognosia can result from a disruption in connectivity in the UF. When exploring connectivity in the frontoparietal network (FPN), Philippi et al. (2015) found reduced connectivity in those with higher scores on the PCL-R, which included the right precuneus. And to further the overlap, Glenn et al. (2009) [8] found that those with who scored high on the interpersonal factors of the PCL-R (manipulative, conning, deceitful), showed reduced activity in the PCC during an fMRI scan when having to make judgments during moral dilemma scenarios.

Anosognosia and psychopathy both demonstrate complex neurological constructs, and it is premature to conclude that the neurological basis for Anosognosia (itself still understood) would tuck neatly into the already known neurological research on the psychopath. However, given the neat juxtaposition of behavioral traits and neurological dysfunction, it is worth bringing psychopathy into discussions of Anosognosia for the following reason. The research on psychopathy is currently deeper and richer than the research on anosognosia, and behavior of the psychopath has been widely observed and studied. If we can reasonably conclude that psychopaths, particularly criminal psychopaths, are also anosognosics, their behavior can be assessed in light of what it means to recognize no disorder or defect within oneself. The parallel is further relevant with psychopathy when considering that a number of those with schizophrenia, and a minority of those with AD, have been known for antisocial, and sometimes criminal, behavior [9, 10].


Those with schizophrenia and AD also suffer from abuse, but when they have been known to act violently, their behavior and motivations need to be understood. Torrey (2012) has documented extensively the violent acts of those with schizophrenia [2]. There is usually a history of progressively worse episodes of psychosis that can convince the patient that they are receiving supernatural or alien instructions to kill or harm individuals, and more often than not family members. Whether or not the auditory hallucinations slowly convince the patient over time of the necessity for deadly action, or whether the act is impulsive, after the event the patient often remains remorseless and attributes their behavior to necessary and mandated (often divine) reasons. This state of mind is similar to the violent psychopath, who also viewed his violent actions as necessary and fully justified. The problem is never attributed to the self; a disorder or defect is not recognized. While psychopaths are widely regarded as not having a conscience and experience only limited affect, more research is needed on the experience of conscience by schizophrenics, especially understanding the role that psychosis played in circumventing the conscience and providing them with permission to act. It is also crucial to discover how those events are remembered and felt post psychosis, perhaps when the patient has reconvened their medication.

In illnesses and disorders that can be associated with antisocial behavior or aggression, anosognosia could be a partial reason for the event of the behavior. Not recognizing any problems or defects, and thinking that one acted rightly or righteously, will affect personal judgments on the self-evaluation of behavior. This does not provide a fertile ground for remorse or responsibility, and if the behavior was aggressive, the patient could continue to remain dangerous, inflexible to a reasoned and peaceful behavioral change. This makes the search for the neural representation of anosognosia all the more crucial, treatment all the more pressing, and methods of identification all the more necessary.

© Jack Pemment, 2016



  1. Perrotin, A. et al. (2015). Anosognosia in Alzheimer disease: Disconnection between memory and self‐related brain networks. Annals of neurology, 78(3), 477-486
  2. Torrey, E. F. (2012) The Insanity Offense, New York, W. W. Norton and Company
  3. Ries, M. L. et al. (2007). Anosognosia in mild cognitive impairment: relationship to activation of cortical midline structures involved in self-appraisal. Journal of the International Neuropsychological Society, 13(03), 450-461
  4. Gerretsen, P. et al. (2015). Illness denial in schizophrenia spectrum disorders. Human brain mapping, 36(1), 213-225
  5. Hare, R. D. et al. (1990). The revised Psychopathy Checklist: Reliability and factor structure. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2(3), 338-341
  6. Umbach, R. et al. (2015). Brain imaging research on psychopathy: Implications for punishment, prediction, and treatment in youth and adults. Journal of criminal justice, 43(4), 295-306
  7. Motzkin, J. C. et al. (2011). Reduced prefrontal connectivity in psychopathy. The Journal of Neuroscience, 31(48), 17348-17357
  8. Glenn, A. L. et al. (2009) The Neural Correlates of Moral Decision-Making in Psychopathy. Retrieved from
  9. Fazel, S. et al. (2009). Schizophrenia and violence: systematic review and meta-analysis. PLoS Med, 6(8), e1000120
  10. Lopez, O. L. et al. (2003). Psychiatric symptoms vary with the severity of dementia in probable Alzheimer’s disease. The Journal of neuropsychiatry and clinical neurosciences, 15, 346–353

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.


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

Emotion and Worldviews: The Deep Empathic Failing of Homophobia

Anchor and balloonLately, I have been trying to make sense of how our emotions and our sense of morality are related. Everyone has ideas about what is ‘right’ in the world, and these ideas are usually held as explanations for having certain feelings about particular events. For example, witnessing an assault or abuse can make us feel bad (if our brain is working). We then justify our bad feeling with ideas that explain why we feel bad, and we soon have a sense of morality.

First, we might reason that the aggressor is wrong for behaving aggressively because we don’t like the way we feel when we witness what he is doing, or the way we feel when he is doing it to us. To make further sense of these feelings we start weaving together ideas, such as hitting people is wrong (it has to be, right, because it makes us feel bad?), and extend it to hitting smaller and weaker people is more wrong (because this change in context makes us feel worse). However, we might start to introduce caveats such as, hitting people is wrong, unless it’s to stop someone hitting someone else. And so as our emotional responses change throughout these different scenarios, our sense of morality and the way we understand the world evolves.

The key point to note here is that our emotions anchor our morality. It is also possible to have a cold and emotionless ‘code of ethics’, a system of rules that govern behavior, even though there is no emotional attachment to them. In fact, your emotion and the cold and emotionless ethical principles that you come into contact with probably duke it out to give you your sense of morality. Lacking an emotional attachment could cause a schism and internal conflict later, especially if we have (intellectually) accepted a moral position with no feeling, such as a stance on the death penalty or abortion. Should we experience for the first time a personal situation that involves these two issues, our emotions may go to war with our intellect.

But there’s no denying that the ideas about life that really stick, are the ones weighted down by a strong emotion, and this becomes problematic because our emotion, which is notoriously unreliable, becomes the first and often the most powerful truth criterion for understanding a moral action. If we feel strongly positive or negative towards something, that’s sometimes all the truth we need – our visceral experience.

I believe that it is this visceral failing that results in the most prejudice. For example, take homophobia. Sometimes it is touted that homophobes are really self-hating homosexuals. While I’m willing to merit that this is sometimes the case, I do not think it explains the majority of homophobia. What explains the majority of homophobia is a deep empathic failing – all justifications on top of this are all garbage, no matter what their brand. However, these justifications also form a culture that reinforces these deep empathic failings. Let me explain.

A heterosexual teenage male, with a new found and celebrated sexuality, will realize how awesome women can make him feel (this marks the beginning of personal growth and many political encounters with women, which will hopefully result in positive outcomes). Now, in an effort to understand homosexuality, there’ll be an attempt at empathy and he may fail miserably. In all likelihood he will recreate the experience of anal penetration, or imagine all of the sexual things he fantasizes about one day doing with a woman and supplanting the woman with a man. This will make him want to retreat into his shell like a turtle, and the bad feeling that results from this failed empathy could then easily be justified by bogus ideas of what it is to be gay. If the feeling is strong (or repulsive) enough, the quality of any further truth criteria doesn’t matter – the repulsion is his experience – his truth (I haven’t been to church in ages, but let me throw out Leviticus, and then show you this sour expression on my face).

There was a deep empathic failing here for the following reason.

The great feeling arising from the heterosexual sexuality will hinder attempts at homosexual empathy, and to a large extent, a heterosexual male will never know how awesome it feels to fall in love with another man. But this doesn’t matter. What the heterosexual person can empathize with is what it is to love somebody and be attracted to somebody. How great it is to curl up on the couch after a long and trying day with their significant other. If the empathic focus shifts from physical sex to the emotional satisfaction (or turmoil) of being in a relationship, empathy can prevail. Given time and maturity, the awkwardness elicited by thoughts of homosexual sex can also be diminished.

The problem is that homophobic ideas do focus on sex and encourage negative feelings, which in turn reinforces homophobic morality. It’s a particular problem with sex because the emotional experiences that result from our sexuality are often so powerful that there is no neutral ground – something is either very wrong or it’s very right. This is why sex is usually a major part of religion – the strong feelings of guilt (or in some cases empowerment) strengthens the underlying creed, which may force some to disband and others to cling even tighter.

I believe that a failure to empathize on this crucial issue could be addressed by mentioning sexuality in school. Firstly, it’s crucial that homosexual children can learn that there is nothing wrong with them, which is vital for their development, and secondly children/teenagers can learn some theory surrounding relationships. Obviously, there is much to be learned from experience, but some good foot holds from the beginning could be beneficial. It is perhaps time that children are shown how to empathize, because their morality depends on it.

Hervey Cleckley and Psychopathy

Hervey Cleckley. Photo from Wikipedia.

Hervey Cleckley. Photo from Wikipedia.

Hervey Cleckley is arguably one of the first mental health researchers to make sense of psychopathy. He worked as a psychiatrist in the Department of Psychiatry at the University of Georgia School of Medicine. In 1941 he published The Mask of Sanity: An Attempt to Clarify Some Issues About the So-Called Psychopathic Personality. As you can guess by the latter part of the title, in the 1940s there was a lot of confusion about what psychopathy was and how it should be addressed – not just how the public saw it, but how it was treated in legal and psychological/medical circles. In fact, at the end of an article Cleckley wrote for Federal Probation in 1946, he admits, “Psychiatry has not yet been able to prove or demonstrate precisely what is wrong with the psychopath.”

There were a least a couple of reasons for this confusion. First, psychopathic individuals appeared to commit crimes impulsively, even knowing that what they were doing was legally wrong. Cleckley wrote, “While on parole for stealing something [the psychopath] did not need, he will steal again, often taking an object he does not particularly want, and under circumstances that he knows may result in his being discovered as the thief.” This behavior was deeply puzzling, and it must have appeared that the psychopath was acting self-destructively. Now we of course can easily distinguish between knowledge of the law and feeling what is morally right. And we have also hypothesized that psychopaths often get their psycho-physiological kicks from acting recklessly and abusing other people, kicks that are far more important than any legal consequence.

The second reason for this confusion was that the psychopath appeared to act perfectly normal, right up until the very moment that they didn’t. This made it hard to determine whether or not the psychopath knew what was morally acceptable and whether or not they met the legal definition for insanity. The psychopathic offender wasn’t hallucinating. They didn’t display any evidence of brain damage as measured by instruments and tests of the day. The psychopathic behaviors of pathological lying and manipulation made it increasingly difficult to gauge the sincerity of the individual, and that still poses a problem for people today, including trained psychologists.

The writing of Cleckley is actually very amusing. It certainly betrays a stereotypical male attitude from the 1940s. For example, when describing the behavior of the psychopath, Cleckley writes, “Not rarely the records will show that [the psychopath] has won the chancellor’s prize at college for an essay on the Renaissance, or graduated from high school summa cum laude, or outstripped 20 rival salesmen over a period of 6 months, or married the most desirable girl in town.” I think Cleckley overestimates the intelligence of psychopaths to the point where he thought psychopathy and intelligence were naturally entwined, but writing about the Renaissance? To Cleckley, perhaps that is the epitome of scholarly brilliance. But marrying ‘the most desirable girl in town’ is surely a reflection of male chauvinism, even though psychopaths might enjoy the status of being with a beautiful woman.

Another example of Cleckley’s 1940s attitude comes through with, “If [the psychopath] escapes detection [for theft] he will repeat his stealing or perhaps forge a check or noisily entertain a prostitute in the apartment of his respectable and devoted aunt who is away on a week’s vacation.” I feel like this quote speaks for itself.

I have yet to come across any evidence that Cleckley believed women to be psychopathic. If anyone knows different, I would appreciate a reference. The psychopath is always addressed in third person male, which while is a writing bias, I’m sure it also reflects that many (if not all) of the psychopaths Cleckley studied were male. Even now it does seem like most psychopaths are male, but it has been suggested that the diagnostic criteria for determining psychopathy has come from male-dominated research. It is possible that the behaviors of the psychopathic are expressed differently in men and women. In fact, some believe that women are more likely to be diagnosed with Borderline Personality Disorder (BPD) than Antisocial Personality Disorder (APD – this is fairly closely related to psychopathy), because BPD reflects an emotional instability that is strongly associated with women. This bias could naturally lead to the wrong diagnosis.


Cleckley, H. (1946) The Psychopath: A Problem for Society, 10 Federal Probation 22 (22-25)

Guns, Civilians, and Reactive Aggression

Curtis Reeves. Photo by Brendan Fitterer/AP

Curtis Reeves. Photo by Brendan Fitterer/AP

The recent shooting of Chad Oulson (43) by retired police officer Curtis Reeves (71) has helped me to solidify my view of civilians having guns. After what seems like a few heated exchanges that may have involved expletives over texting in a movie theater in Florida, Reeves shot and killed Oulson.

This incident highlights something very unique about gun possession. During times of reactive aggression, it is ridiculously easy to shoot and kill somebody if a gun is present. Reactive aggression is the result of somebody becoming so stressed and agitated that their mind turns to the flight or fight response. This brief moment is a moment of little to no reason, even a moment of temporary insanity. Somebody such as Reeves, in the age of retirement and with his spouse, is not going to entertain the ‘flight’ part of the fight or flight response, especially if he has the ultimate weapon of attack at his disposal.

The other type of aggression is instrumental aggression, where somebody deliberately plans out and executes the use of violence for power, entertainment, or perhaps respect (personal goals). During times of instrumental aggression, the type of weapon loses significance, because it’s a planned act of violence. During moments of reactive aggression, it is all too easy to shoot and kill, as opposed to wheeling a baseball bat or a hammer, or chasing somebody down with a meat cleaver. By the time the aggressor has thought about or attempted to injure a person with a bat, the moment of reaction has passed, and clarity has returned.

Reactive aggression is by far the most common type of aggression in society. Those flare ups we all have and quickly get over.

I am also convinced that many gun owners do not want or plan to injure or kill anyone. Clearly, it’s the gaining ‘control’ that appeals to gun owners. The only trouble is while they’re holding the gun they are losing mental control as their emotions start to tug on primitive survival instincts, and the presence of a gun is going to ignite the flight or fight response of those the gun is being aimed at. In fact, unless you have been trained to use a gun in these circumstances, the control you think you have is illusory.

One last thing that I think proponents of gun possession never fail to overlook, is the impact of what killing somebody would do to them for the rest of their lives. Even if killing is not the intent, it is still a very real possibility while a gun is present. Reeves now has to rationalize to himself, for the rest of his life, that killing Oulson was a necessity. He is going to fail at this, time and time again. He is going to lose sleep over it. He is going to struggle to see the world the same way again. In fact, one could argue that the impact this event has had on his mind and conscience is already his sentence for the crime.



The Guardian: Florida judge denies bail for retired cop accused in fatal cinema shooting