Sunday, February 9, 2014

The Psychopath Inside Comes Out

Unlike much of the public, I don't have a lurid fascination with psychopaths. I don't like true crime novels or television shows, and when I've occasionally read novels from the point of view of a psychopath (such as one of the earliest John Rebus novels by Ian Rankin), I resented the author for it.

I had a bit of that feeling while reading James Fallon's The Psychopath Inside: A Neuroscientist's Personal Journey into the Dark Side of the Brain. Fallon, as I mentioned earlier, realized that the fMRI of his own brain looked a lot like those of the psychopaths he studies. He has no criminal history and has never been violent, though, so it's not the same as being forced to share thoughts with a killer.

On the other hand, he is massively narcissistic, which gets to be a bit much. I'm glad I'm not related to him, and I wonder how his wife (of 44 years) puts up with him. It made me glad it was only 227 pages with the widest linespacing I've ever seen in a book meant for adults.

Despite the annoyances, there are some revelations in the book.

Psychopaths are identified by their scores on something called Hare's Checklist. A perfect (psychopathic) score is 40, with 25 or 30 used as the cut off. The factors are interpersonal (deceitfulness, grandiosity), affective (lack of empathy, lack of remorse), behavioral (impulsivity), and antisocialness.

People with autism are not at all like psychopaths. "People with autism lack theory of mind but not empathy, while people with psychopathy lack empathy but not theory of mind" (page 55).

Fallon is descended from a long line of people who may have been psychopaths, starting with King John I of England, extending to the first matricidal killer in the colonies (Thomas Cornell, 1673), Lizzie Borden of axe fame, various other men (and a few women) convicted of murder, and one string of wife-abandoners. He acknowledges that genetic dilution through the generations makes this a bit dubious, but it's notable, nonetheless.

The so-called warrior gene, identified by Dutch researchers in the 1990s, is X-linked and therefore much more common in men than women. There's a 30 percent incidence rate of the gene generally and for men, but for women it's 9 percent (since we have two X chromosomes and it would have to be present in both). The warrior gene is not the same thing as psychopathy but they can easily coincide in the same person. (The rate of warrior gene incidence is higher among Africans, Chinese, and Maori, he says. He theorizes that it is lower in gene pools that come from places that were geographically protected from outsiders.)

Fallon proposes a three-legged stool as a metaphor for how psychopathy comes to exist in a person: one part genes, one part a particular pattern of brain functioning, and one part early childhood abuse. "I looked at all the case studies I could find...and saw that for all the psychopaths, including dictators, who had psychiatric reports from their youth, all had been abused and often had lost one or more of their biological parents" (pages 90-91).

The earlier the abuse happens, the bigger the effect it has. In-utero stressors would be the worst, but the "fourth trimester," the first several months of life, is almost as important.

Another crucial time is the teen years. It's well-known that schizophrenia, bipolar disorder, OCD, and other personality disorders often develop in these years. "Stressful stretches of a young person's life such as college, first marriage, and especially military combat couldn't come at a worse time for the developing prefrontal cortex" (page 101). Fallon agrees with me that "sending kids to war at eighteen is ridiculous" (page 101). He advocates a minimum age of 22 or 23.

Fallon describes, with almost too much painful detail, how he feels about his family and friends, how he manipulates, how he doesn't really care. He then says he thinks of himself as a prosocial psychopath, and that Bill Clinton may be like him (pages 161-162). He also speculates that there may be a "Libertarian brain" that looks a lot like his. My favorite political quote: "I wouldn't let a kid starve right in front of me -- I'm not a monster -- but if I ran the government I would cut out all welfare" (page 164). He goes on to say he thinks it's fine if the "weak" or "lazy" die.

If you've ever wondered who the person is that cuts in line without a thought, who intentionally parks in two or even four spaces, who thinks the rules don't apply to him, it's Fallon and people like him:
When I see a sign directing me to park somewhere proper and legal...I will continue to ignore the rules, knowing that the sign is there to serve whoever put up the sign, and not the rest of us. I'll find a place on the grass or next to a real space close to the door.... While these scofflaw behaviors are not really psychopathic in any serious sense, they do signify I can be a real jerk, or, as less polite people may call me, an asshole (page 207).
He ends the book by speculating on what evolutionary advantage psychopathy offers the human race (because if it didn't have one, it wouldn't be so prevalent). They make strong warriors, for one thing, and probably inventive leaders, since they can disengage emotionally from the action around them and they don't care what others think. (They're unlikely to suffer from PTSD, too. Bonus!)
All combinations of strengths and weaknesses become manifest in humans, and this both helps and harms individuals, but also add to the group. They also add to group diversity, the ability for at least some of us to survive any extremes of plague, climate change, or total war. Within this outlying group are the psychopaths, who in peaceful times act as predators and opportunistic parasites in a society, but under times of tremendous danger may save the day and continue breeding, albeit at the cost of keeping their traits in the gene pool for as long as humans exist (page 225).
Despite its insights, I'm glad to be done with the book and out of this particular psychopath's brain.

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