Tag Archives: sociopath

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

What’s in a name? The fickleness of sociopathy: Ideas, the suspension of the conscience, and why psychopathy is completely different

(For a PDF version, click here)

There is one question that can often haunt research on mental illness and mental disorders. Simple as it may seem, “What should we call it?” can often pose no end of obstacles, and result in long drawn out debates in the mental health and medical profession. One reason for this is that certain maladies often have numerous dimensions, and symptoms can present differently in those afflicted. Typically, through extensive research, diagnostic criteria are established under the banner of one name; pick up the DSM-V or the ICD-10 and you’ll see the names for all kinds of illness and disorder, with thorough lists of all the symptomatology that is now accompanied and unified under a common name. But these symptoms are often present in other conditions, and present in the patient to different extents. Rendering a diagnosis is indeed a tough challenge for any mental health professional.

 

Another reason that makes it difficult to name a particular mental health phenomenon, is that there is sometimes an inclination for the name to include the developmental origin. This struggle is perfectly captured in the history of psychopathy research. Cleckley, arguably the first psychiatrist to make strides in classifying psychopathy, writing in the 1940s devoted many chapters in his book, The Mask of Sanity, to discussing how the term and the individual were currently seen by the mental health establishment.

 

Every physician is familiar with the term psychopath, by which these people are most commonly designated. Despite the plain etymological inference of a ‘sick mind’ or of ‘mental sickness’, this term is ordinarily used to indicate those who are considered free from psychosis and even from psycho-neurosis.

Cleckley, The Mask of Sanity[i]

 

Clearly, in the mental health profession, a term denoting a ‘sick mind’ is not particularly useful in attempting to make a diagnosis, as it perhaps captures every possible mental malady that can afflict the human brain. However, the term does appear to capture those who are free from psychosis and psycho-neurosis, while still indicating that something is awry within these individuals. The truly psychopathic are renowned for behaving in socially pleasing ways, at least temporarily, before they are implicated in acts of antisocial behavior, sometimes even downright grotesque or horrendous behavior. This nature of the psychopath puzzled mental health experts and laypeople alike, as they pondered how one person could exhibit such extremes of behavior, sometimes in a short space of time.

 

Later, the term ‘psychopath’ clearly evolved and took on new meanings as research on this dangerous personality disorder progressed in the twentieth century. As the esteemed psychologist, Robert Hare, pointed out:

 

[Those] who feel that psychological, biological, and genetic factors also contribute to the development of the syndrome[,] generally use the term psychopath.

 Hare, Without Conscience[ii]

 

Hare stated this in contrast to those who were using the term ‘sociopath,’ who according to Hare were convinced that social factors and early experiences were responsible for the manifestation of this particular disorder, and subsequently this particular type of person, in society.

 

This appearance of two names for the same disorder (psychopathy/sociopathy), and the same person (psychopath/sociopath) becomes problematic. Not only is having two different names for the same condition a little redundant, but the developmental origins, the initial reason for having the two different terms, all belong together. Social factors, early childhood experience, psychological, biological, and genetic factors, all collapse into a uniform analysis of the one condition. Social factors and experience immediately become psychological and biological factors on the level of the brain, and these factors can have a direct impact on the level of gene expression. This is even more profound when the brain is still developing during the formative years, when certain kinds of abuse can result in neurological developmental errors.

 

In early 1990, Hare and his team devised what became the psychopathy checklist, revised.[iii] This built upon earlier research that resulted in the psychopathy checklist,[iv] and has become the gold standard for diagnosing psychopathy. The list is composed of two sets of behavior, dividing them into antisocial traits and personality traits. This diagnostic tool generates a total possible score out of forty, and after a mental health professional has assessed the behavioral history of an individual, any score given in the high twenties and over thirty is indicative of a psychopath. Using this tool, many neuroscientists have created experimental groups of psychopathic individuals and have found unique brain differences between the psychopathic and the non-psychopathic. And so, despite ‘psychopath’ being a vague and somewhat empty term in Cleckley’s era, psychopath research today is incredibly rich from behavioral and neuroscientific input. This richness, coupled with the collapse of social factors in with the biological to describe the same condition, means that the term ‘sociopath’ should be extricated from discussions of the disorder.

 

The term ‘sociopathy’ does become useful again when considered in another context. Hare and Babiak described ‘sociopathy’ in their book, Snakes in Suits, thusly:

 

Sociopathy is not a formal psychiatric condition. It refers to patterns of attitudes and behaviors that are considered antisocial by society at large, but are seen as normal and necessary by the subculture or social environment in which they developed. Sociopaths may have a well-developed conscience and a normal capacity for empathy, guilt, and loyalty, but their sense of right and wrong is based upon the norms and the expectations of their subculture or group.

Hare & P. Babiak, Snakes in Suits[v]

 

This definition is really what sets the two terms apart. Psychopathy is understood as a mental disorder and has formal diagnostic criteria; sociopathy does not. Sociopaths have empathy, guilt, and remorse; psychopaths do not. It is this latter point that is the most profound, because neurological studies have shown us that the areas in the brain that are heavily implicated in moral decision-making are typically malformed and mal-developed in the psychopath. This means that the brain of the psychopath, physically and neurologically, will be significantly different from the brain of the sociopath.

 

With this new definition, sociopathy becomes so much more useful to us. We can now ask questions such as ‘How can someone commit devastating and destructive crimes if they have a conscience?’ and ‘If a sense of right and wrong is represented in a person’s personal ideology, what power do ideas have in influencing a person to commit crimes?’. Sociopathy presents us with the opportunity to study how those with a conscience can, at least temporarily, act unconscionably. It presents us with the opportunity to explore how those with strong moral codes can promote group solidarity, while treating those not in the group as subhuman; think gangs, or the Mafia, or paramilitaries. Exploring the ideas present in the manifestos of spree killers and hate groups also becomes relevant, as they usually purport a version of history where one or more groups in society present as a threat, and why action needs to be taken against this group. All of these people have a conscience, but over time it appears to have become punctured or torn. Sociopathy could help us to understand why this has happened.

 

If we explore perhaps the most antisocial of behaviors, taking the life of another, sociopathy as a study of the ideas that led up to the act adds to our wealth of knowledge of those with disorders or illnesses that can lead to murder. Not all psychopaths are killers, but it is easy to understand how they can kill. Not having a conscience and not feeling guilt or remorse, perhaps even coupled with the pleasure derived from killing or severely injuring others, could easily lead to the act being carried out. Others have suffered psychotic breaks, often over a period of time, and aggression has escalated to the point of lives being taken; this has been true in some with schizophrenia and related conditions. Visual and auditory hallucinations can convince them of the need to act, and when this is coupled with paranoia, something that is often present in the schizophrenic, patients are often compelled to act in a manner they consider appropriate and necessary. Now, it is arguable that as a psychopath does not have a conscience, then they are simply unable to develop a complex ideology of right and wrong behavior; but we could find that sociopathy is comorbid with schizophrenia. Auditory hallucinations become part of the schizophrenic’s experience, and thus represent to them a truth about the world. If, like has been documented elsewhere, the auditory hallucinations are believed to be voices from the supernatural, instructing the person to act, the patient could work those instructions into everything else they believe about the world. A patient with a religious faith could easily believe they are receiving divine instructions to end the lives of people who are secretly evil, for example, demons posing as family members. Their hallucinations make their belief system very real to them, and the drive to act comes from a strong sense of rightness, bolstered by the belief that they are perhaps an avenging angel with a divine mission.

 

There are other abnormalities with neurological correlates that could facilitate taking the life of another. Crimes of passion are quite common, where an individual experiences a heightened sexual or stressful state and lost, only temporarily, a state of rationality. Extreme emotions can sometimes dampen the ability to reason and think clearly, with catastrophic consequences. These can often be exacerbated with those susceptible to anger management issues, or serious stress disorders. Sociopathy could also be present here; a homophobic father who catches his child engaged in a homosexual act could prompt a loss of control due to stress and result in extreme violence. The father would have no doubt been exposed to homophobic ideology before witnessing his child in a same sex relationship, and used the component ideas to justify to him what is true about the world. The perceived infraction from the father’s moral code results in the stress and the loss of control. For the most part, the father has a conscience, and loves his child, but his beliefs about the world seemed to couple with witnessing this act, and worked together with poor stress control to temporarily suspend his conscience.

 

Brain tumors, physical damage to neurological tissue, as well as alcohol and drug use, are also all linked to violent behavior. Here, too, an overarching ideology of what is right and wrong about the world, could work in synchronization with these biological changes to motivate destructive behavior, and the compulsion to act aggressively could even further justify the truth value of the overarching belief system; it has to be true (and thus, right), because why would the desire to act be so strong, otherwise? But does something have to be wrong biologically for toxic ideologies to take root and influence behavior? This is also a question that merits further research. Experiencing the world negatively, either because of something biological, or maybe just suffering from intense psychological hurt and pain, would be enough to make a person crave understanding. During this time they will be receptive to any ideas that seem to explain the negativity, and perhaps claim to provide an answer to end or cure the suffering. This wouldn’t explain all sociopathic behavior, but it would go a long way to understanding its onset.

 

Sociopathic behavior could result if over time, exposure to negative ideas helped to diminish empathy towards other people, and is perhaps demonstrated best by considering the lives of spree killers. Elliot Rodger, Seung-Hoi Cho, Dylan Roof, Anders Breivik, and Christopher Dorner all wrote lengthy manifestos, and some maintained websites and made Youtube videos detailing their grievances at great length. There are various mental illnesses and disorders that have been implicated in the lives of some of those individuals, but it is sometimes hard to substantiate if a diagnosis was made or not. Regardless of conditions or disorders, the manifestos represent a detailed view of the world, as seen by these individuals, including what is wrong with it, and usually what in their view has to happen to fix these societal ills, perhaps taking the form of retribution and revenge. Constructing a manifesto takes a lot of time, and is a significant personal investment for the author; they have taken the time to create a reflection of the world that is accurate to them, built up of the ideas that they think represent the truth and depict reality. The tremendous effort and planning that goes into the manifesto begs the question of what role the manifesto played in bringing them up to their final act. Was it to help them understand why they needed to do what they felt was necessary, thus allowing their conscience to at least temporarily bend to murderous inclinations? Did it help to commit these acts, knowing that people could use the manifesto to understand why it took place, even though they no doubt accepted they would not be alive to witness this ‘understanding’? Finally, if hypothetically they were unable to put a manifesto together, or they believed nobody would ever understand their actions, would their final act still have taken place?

 

There is also the question of how ideology and determining what is true about the world can change after the experience of psychotic episodes. If auditory hallucinations convince a patient of imminent threats or inevitable actions, what the patient believes is true about the world could change; ideas that promote certain kinds of behavior are adopted to achieve goals that fit into an evolving ideological framework. When the psychotic episode has subsided, does the imminence and immediacy of these ideas decrease? Are the ideas eventually discarded as an inaccurate representation of the world? Psychotic episodes are no doubt traumatic because they force the patient to reassess how they are seeing and understanding the world around them, and the more they are forced to reassess, the more traumatic the experience. After a string of psychotic episodes, the patient could well still harbor ideas that became prominent during the last episode, and so certain inclinations that become mandatory are eventually expected. The entanglement of psychosis with ideas and conceptual representations of the world is clearly a crucial study, and could well illuminate the state of the patient’s conscience.

 

This study of sociopathy would also apply to soldiers, who have to be prepared to kill, and destroy infrastructure that could decrease the standing of living for civilians. Soldiers are trained to incapacitate or take the lives of enemy combatants, often by a bloody and violent means. For a soldier to be able to take this action, they have to at the very least temporarily suspend empathy towards other human life, and be comfortable after the carnage with the actions that were taken. Soldiers obviously go into the military with a conscience and do not join out of a love or desire to kill (there is certainly screening to catch this disposition). Ideology can assist with coming to terms with needing to kill, particularly those of nationalism and patriotism; believing that some war is unfortunate but necessary, the war was just, evil has been prevented, and the enemy is a direct threat upon one’s way of life (which is right and true).  When these ideas fail to resonate as true, perhaps based upon personal experiences, the life of soldiers can become a living Hell, especially if they are also suffering from stress-related disorders brought on by extended periods of combat.

 

If we take sociopathy to mean the use of ideology to at least temporarily suspend the conscience or diminish empathy towards others, the example of soldiers as sociopaths opens up an interesting dimension to the discussion. Regardless of political inclinations or personal worldviews, most people would reluctantly accept that sometimes it is necessary for soldiers to kill. Sometimes people have to kill other people. Most of us are fortunate in that we have people who do it in our stead, and we trust them to make those decisions and take all the necessary precautions to keep it as ethical as it can be. If one of the primary purposes of the soldier is to be prepared to kill, then within this framework of sociopathy, we condone the training of sociopaths to carry out this necessary and deadly behavior.  Here, it is crucial to keep this framework of sociopathy in mind, and not treat it as a synonym for psychopathy. Soldiers are not psychopaths. It would be a worthwhile study to track soldiers’ ideologies throughout their careers in the military, because exposure to extreme combat is likely to force the soldier to reassess how they see the world, in a similar manner to schizophrenics experiencing psychotic episodes (a severely agitated mental state, prompting a new understanding of reality). Any time that reality is re-assessed, values of right and wrong can be re-considered, and this will reflect in the overall conscience of the individual. Those forced to re-evaluate the world, due to agitation or trauma, will become open to new ideas and vulnerable to toxic ones, which is one of the reasons why these individuals need constant help and attention.

 

Connecting the dots between ideology and conscience is clearly of paramount importance if we hope to understand violence. This goal can be met with an open, honest, and concerted effort to study sociopathy on the level of the brain, the individual, and society.

© Jack Pemment, 2016

 

References

[i] Cleckley, H., The Mask of Sanity (3rd Edition), EPBM, Brattleboro (2015), p. 27

[ii] Hare, R. D., Without Conscience, Guilford, New York (1999), pp. 23-24

[iii] Hare, Robert D., Timothy J. Harpur, A. Ralph Hakstian, Adelle E. Forth, Stephen D. Hart, and Joseph P. Newman. “The revised Psychopathy Checklist: Reliability and factor structure.” Psychological Assessment: A Journal of Consulting and Clinical Psychology 2, no. 3 (1990): 338

[iv] Harpur, Timothy J., A. Ralph Hakstian, and Robert D. Hare. “Factor structure of the Psychopathy Checklist.” Journal of consulting and clinical psychology 56, no. 5 (1988): 741

[v] Hare, R. D.; Babiak, P., Snakes in Suits, Harper, New York (2007), p. 19

Training the mind to devalue the lives of others

SociopathyWherever we find crimes against humanity, there is a good chance we will find ideology. And I don’t mean ideology to suggest extremism, just simply the presence of ideas that are used to justify or explain the crime. Whether the crime was intentional, whether it was because of one or many perpetrators, or whether it was accidental, ideas (which may have been present before the crime) will always quickly follow the crime in order to dampen the conscience.

To be sure, a conscience does have to be present in order for it to be dampened. The clinical psychopaths among us are not going to suffer a crisis of conscience should their behavior threaten the livelihood of others. Ideas may be tossed around in a courtroom in defense of their actions (prison is still an inconvenience for a psychopath), but they will not be needed to stop their mind from spinning out of control due to the powerful rehabilitative and sometimes crippling actions of a conscience.

There can be little doubt that our capacity for empathy plays a role in our conscience, after all, it is our empathy that truly allows us to experience the drive to treat others as we ourselves would like to be treated (the Golden Rule). It is truly an admirable state of humanity that one can witness the pain of another and then feel the drive and motivation to end that pain, although this in itself could become part of an ideology that results in the systematic murder of many people to fulfill the goal of ending pain and suffering. And there is also the small caveat of ‘feeling’ another person’s pain with the desire of inflicting more pain, perhaps for the sadistic desire of torture or the cockeyed belief of using pain to gain information.

It is widely acknowledged that there is a dual component to empathy; emotional and cognitive. Emotional empathy represents our strong feelings when we recreate the emotional experiences of others, and cognitive is when we use our reason to understand what somebody must be feeling. These two work together to create our empathic experience, and this experience is the gateway to how we will perceive ourselves after witnessing or thinking about an emotionally salient event. If we are directly involved in the event our conscience is going to want to weigh-in on how to feel, and if we cherish our peace of mind, we have to successfully navigate through our empathic experience of the event and find personal vindication.

The only problem is we can cheat.

As our cognitive empathy is based upon ideas – such as somebody else said they’d call an ambulance, everybody’s doing it, I would’ve caused an accident if I’d have stopped, they were faking so they could rob me – not only can we retrieve our actual memory of events, but we can use our imagination to interpret those events. It doesn’t matter how objectively true or valid these ideas are as far as our conscience is concerned, it is just that we believe them. And nothing validates an idea like other supporting ideas or the agreement of the idea by those we love and/or trust. When the conscience comes knocking, it is the cognitive component of our empathy that can send it on its way. And if certain ideas are heralded as true before an event, particularly a criminal event, such as women are fundamentally different and so need to be treated differently, or they would have killed me if I hadn’t acted, then the inhibitive impact of a conscience before a criminal event and its crippling affect after an event, won’t even be an issue and provides free license to aggressors.

Psychopath experts Robert Hare and Paul Babiak discuss the meaning of sociopath in their book Snakes in Suits. They define it as a person who has a sense morality (unlike a psychopath), but the morality comes from a sub-culture. These people have a sense of right and wrong, but their worldview morally permits them to behave in ways that are harmful to others. Such a sub-culture could be Anti-Semitism or White Supremacy, or any set of beliefs that devalues the lives of others (homophobia, misogyny, racism, ageism, etc.). Sometimes the belief systems aren’t even as extreme as we might think – nationalism, patriotism, and religion have all been used to devalue the lives of others. Beliefs that some of us cherish, such as love of country and love of God, even though seemingly innocuous and noble, could easily be borrowed by new ideas that support devaluing the life of others (such as those who don’t share those beliefs), all to appease our actions and deflect our conscience. The content or nature of the ideas doesn’t matter. If they’re used to devalue life, we’re talking sociopathy.

Of course, somebody who systematically devalues the life of others would not view this as devaluing (how can you devalue something that has no value to begin with?).  Those who recognize and feel that they devalued the life of others can make amends and adjust their future behavior, and this can be for something simple, such as stealing somebody’s pen, to denying a person their basic human rights. In the latter case, if those human rights aren’t even recognized due to a person’s ideology (the guiding force behind cognitive empathy), an aggressor has a powerful weapon to bat away the conscience and perpetuate harmful behavior.

A Sense of Future and the Act of Killing

Nietzsche future pastIt’s easy to forget how much the ideas we have about our own futures impact our daily lives. We all try to invest in our futures (financially, academically and intellectually, and emotionally and genetically) so that when ‘it’ arrives we will be comfortable and happy. Ideas of a comfortable future make us feel happy, and conversely, thoughts of a chaotic future fill us with dread and peptic ulcers. How we end up in the future is in some ways besides the point, because what we are really trying to do is feel satisfied and happy in the present – by doing what we need to do to secure good thoughts of the future.

Thoughts of the future are intimately related to our sense of morality. Take the golden rule, for example – treat others as you yourself would like to be treated. How would you like to be treated? We need to think about a hypothetical future scenario that involves us being treated a certain way and deciding whether or not we would like it. I say hypothetical future scenario, rather than simply hypothetical, because hypotheticals depersonalize the scenario, and the whole point is that you imagine an act happening to you. Imagining a future scenario overcomes this problem.

Furthermore, if we begin to lose interest in the outcome (future realization) of various activities, we will start to neglect those activities. This is not a moral issue if we no longer care to play the piano, but if we are no longer interested in personal relationships, we can start to neglect people. In fact, a common reason for romantic relationships to fail, is that at least one person in the relationship doesn’t see a future. Considering and being considerate towards your own future and the future of those you care about is clearly moral behavior.

In order to achieve these happy future thoughts, we often set ourselves certain rules and make plans governing our behavior, usually in the name of saving money, staying healthy and in shape, and maybe trying to shape the behavior of our children by being strict. All of the rules are often at the expense of fun and cheap kicks. So, every now and again, we decide to Seize the Day! and completely forget about the future. Obviously, when we do choose to forget about the future and live in the moment it’s still done in a controlled way – none of us really believe that the day to be seized is the be all and end all of our lives.

So what has any of this got to do with killing?

A point that I hope I’ve impressed upon you is that by limiting our sense of future, there is also the danger of relaxing and disregarding our own rules and ethics. I think a ‘sense of future’ actually plays a very potent role in the brains of killers. Below, I have listed what I consider to be the different types of killer (excluding military and legally sanctioned killers), and how a sense of future helps to determine their actions. I have stereotyped each one, but obviously in reality the categories could overlap to varying extents. Brains are dynamic and constantly changing, and so the act of killing only reflects a brain at one moment in time promoting the act within specific contextual cues. Clearly, other people kill in self defense, by losing their temper, or perhaps because of the psychotic symptoms of a mental disorder, and a sense of future may or may not play a role in those events. Regardless, I just want to focus on these three:

Psychopathic Serial Killer: Psychopaths lack a sense of morality and struggle to understand or empathize with emotion. It seems that most serial killers accept that abduction, raping, and killing is going to be a part of their life. Upon this acceptance, and knowing that their behavior can only be continued by evading capture and suspicion, serial killers plan out future events, and are often very meticulous in doing so. It does appear, though, that some psychopathic serial killers do have genuine empathy and morality, but it is only temporal. During these moments they are genuinely able to forge meaningful relationships and lead a ‘normal’ life. Other times, a capacity for empathy isn’t temporal and only limited or faked relationships are possible. This means that serial killers are likely to  fall on a spectrum between a dark/normal life and a dark/faked-normal life. Capture means that both lives are finished, and given the nature of the necessary dark life, a sense of future is integral to the intellectual machinations of the serial killer.

Sociopathic Killer: Sociopaths have a sense of morality, although it’s different from the morality of the parent culture. This means that the sociopath has values or a worldview that one, differs from most people, and two, includes beliefs that devalues or denigrates the lives of certain groups of people. If you hold genuine beliefs that the lives of women, those of different skin color to you, Jews, homosexuals, those of a different religion /worldview / or political ideology are worth inherently less than your own life, then you are a sociopath. Some sociopaths are willing to kill for the sake of their outlook, for their ideology to champion the parent ideology, and so in this sense some may see themselves as revolutionaries. A sociopath is unlikely to have a sense of future while the parent culture/morality remains. As we have already discussed, to lack a sense of future can lead to being unhappy and uncomfortable. A sociopath wants a different future, and may be willing to try and forge it through violence.

Spree Killer: Spree killer is a bit of an outdated term now, but it tends to describe those who arm themselves to the teeth and choose a place where they can inflict maximum casualties in a short space of time. James Holmes, the man who killed many movie goers in Aurora, CO, in July, 2012, might fit this category. Spree killers have a tendency to die in a crossfire with police, commit suicide, or hand themselves peacefully over to the police (as Holmes did). For these killers, there doesn’t appear to be any regard for their lives after the act. The act might be planned out to the nth degree, but if you intend to die in a gun battle, take your own life, or hand yourself over to police knowing that you are going to spend life in prison or receive the death penalty, you clearly have no sense of future. No sense of future – no morality.

Anders Breivik, Sociopath: Addendum

From following the various testimony snippets of Breivik, he clearly has twisted cultural values that the majority of us do not harbor. Yet, it is perplexing as to how much of his claims are true. Breivik stated that he created an organization called the Knights Templar, which of course is a borrowed name for the knights allegedly charged with protecting the Holy Grail. The purpose of the Knights Templar, according to Breivik, is to create a new image for national socialism, presumably to oppose what he sees as the enemy, multiculturalism and immigration.

I think it is worth noting that Breivik appears to be ruled and guided by extreme ideology, but to what extent is he manufacturing it himself? Clearly, there is a history of national socialism in Europe and Breivik seems to have sympathies for the Serbian militants who were active during the Kosovo war, so he no doubt has inspirational sources and justifications for his views, but the fact that he wrote his own 1801 page manifesto suggests that his ideology and his behavior are largely a part of his own brain child. This is to put him in stark contrast to killers who appear to have just become wrapped up in the ideology of organizations or charismatic individuals such as Charles Manson.

The only reason I raise this point is because if you “create” your own culture by working in isolation and living hermetically, does that blur the line between sociopath and psychopath? In other words, are you merely justifying your own behavioral inclinations or do you genuinely believe there to be a greater good to your actions? From what I have read of psychopaths, it does not appear that many have complex ideas about a greater good that extends beyond their own selfish desires. Another reason that I believe Breivik to be a sociopath.